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The author is a family physician in Mullica Hill, NJ.
Obamacare is imploding, costing taxpayers billions and repeal is promised, but the only certainty is that Democrats and Republicans are both to blame for the problems.
Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The opinions expressed here are that of the authors and not UBM / Medical Economics.
The 100-year old battle rages on for free market healthcare with individual freedom (Libertarian) vs. crony capitalism (Republicans and Democrats) vs. single payer/socialized healthcare (some Democrats). The special interests continue to wage war via political parties against the people and their physicians.
Seven years ago, Democrats wrote a huge new tax increase and entitlement plan called The Patient Protection and Affordable Care Act, PPACA, or simply ACA. It was designed to feature a “public option,” aka socialized healthcare. Socialized government healthcare or government single payer can't work as you can't provide an unlimited service that ignores human action and consequences.
Although the Republicans suggested many amendments to the bill, including eliminating the public option, they boycotted it in the end. House Speaker Nancy Pelosi (D-California), notoriously said at the time, “We’ve got to pass it to see what’s in it.”
President Barack Obama promised, “If you like your doctor you can keep your doctor. If you like the plan you have now, you can keep it. …Each family will save $2,500.”
The ACA was passed by a narrow margin due to Democratic support in the U.S. Senate. A similar measure was passed by parliamentary wrangling and reconciled with the House bill; again, without a single Republican vote.
The 2,700-page ACA was extremely complex and lengthy, creating over 100 new boards and commissions, and thus, wasn’t likely read by each Democratic member of Congress prior to passage. It forced all citizens to purchase “government approved coverage” from for-profit or non-profit-in-name-only payers. It has forced many states to expand Medicaid and bust their yearly budgets. It narrowly redefined health insurance and forced coverage standards that doubled the cost of insurance for many. One hundred different insurance plans to choose from with each company, dwindled to a dozen. The government designed and spent more $1 billion dollars on a so-called “marketplace” that didn’t function the first weeks of operation and it later was hacked to compromise the privacy of all citizens mandated to use it.
The government threw good money after bad to “fix” the marketplace and exchanges. ACA-created and taxpayer-sponsored cooperative insurance companies quickly bankrupted themselves, taking millions of dollars each with them. Insurance companies designed narrow networks to restrict patient choices and discriminate against patients, employers, physicians and hospitals. Employers either dropped employees’ coverage or passed the costs on to them. Costs went up for everyone, nonetheless profits soared for insurance companies, hospitals and other middlemen dealt special favors by ACA. “Wealth” was shifted from the working middle class to the government cronies and low-income voters for votes.
In the following years, middle-class workers got tired and angry about the “wealth” shift and the loss of their freedom of choice. They elected a Republican House and Senate majority; all who campaigned on the full repeal of Obamacare.
There were half a dozen last year, from the Tom Price Plan (80% repeal) to the Sessions-Cassidy (60% repeal) plan, which our group of physicians at the National Physicians’ Council for Healthcare Policy worked on.
In a surprise upset victory, the country elected Donald J. Trump, whose number one campaign promise was the full repeal of Obamacare. In fact, he asked Congress to put it on his desk and promised he would sign it on day one; a potential victory for middle-class workers.
Out of nowhere, Speaker of the House Paul Ryan (R-Wisconsin), unveiled “A Better Way”” (30% repeal). Just for the sake of definition, a 30% repeal that leaves most of Obamacare intact, is not ipso facto a repeal at all. Then it came up again, tweaked as the Affordable Health Care Act (AHCA) and passed; still not a repeal.
The Senate is now considering a similar bill called the Better Care Reconciliation Act of 2017 (BCRA) (25% repeal), which inserts certain market elements but leaves Obamacare almost wholly intact.
Assuming BCRA passes with some modification after the July 4th recess, the reconciliation of the two bills surely won’t be a repeal of Obamacare at all. Since the ACA seems firmly entrenched in the current proposals, Sen. Chuck Schumer (D-New York) unwittingly hit the nail on the head with his claim that the GOP bill is "rotten at the core."
The Republicans will then have full ownership of the hybrid burning zeppelin of a law; an albatross around their necks for elections to come as the Democrats have messages through the media that they have “killed 23 million people by repealing Obamacare,” which is hogwash.
AHCA and BCRA are not the full repeal voters mandated in electing a Republican majority in the House and Senate, as well as a president that promised to do so. The American people are angry and tired of special interests and big government forcing them to do things and buy things and the loss of their right to choose and pay. This violates the U.S. Constitution. “A government big enough to give you what you want is strong enough to take everything you have," said Thomas Jefferson.
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By the data presented above, it is clear that both major parties in power are conflicted and unduly influenced by major political contributors. It is clear that both parties are bought and sold to big industrial corporate interests compromising their philosophy and stated goals. The Democrats want to increase taxes and borrow money to keep the poor dependent on government and voting for them. The Republicans want to maintain big government and give preferential treatment to corporate interests to gain their votes. It is both sides crushing the taxpayers in the middle.
We, the people, must have a nonpartisan effort to repeal Obamacare and propose legislation to repeal it and allow the free market to provide competitively priced services and a variety of insurance plans, not only few “government-approved” types. States should be in charge of assistance programs like Medicaid, not the feds. Federal government cookie cutter regulation of healthcare fails the individual and loots the taxpayer.
Let’s get competition for insurance companies, hospitals, testing centers and physicians. Let’s get states to design and fund their own assistance programs based their residents’ needs and budget. Let’s get individuals in charge of their own health, healthcare and financing, using Health Savings Accounts (HSAs) through their own personal value systems.
It is time the people took back the country, starting with healthcare, from the big political parties and their cronies. Call your elected representatives now and tell them you want healthcare freedom and to fully repeal Obamacare. Tell them to reject the AHCA and BCRA that fail to fix Obamacare, and pass new legislation to remove big government and their cronies from your individual freedom to choose and pay.
Demand your healthcare freedom and individual liberty!
Craig W. Wax, DO, a family physician in Mullica Hill, New Jersey and a member of the National Physicians Council on Healthcare Policy.