Don’t dare tell me not to dwell on Obamacare

What expert genius really feels we should not “dwell” on ACA exchanges (“Top 2018 Challenges,” Dec. 25, 2017)?

I am watching all my independently employed patients leave our small internal medicine practice because the only things available in Georgia now that ACA (which had some terrible issues) has been gutted is an expensive Ambetter policy which is essentially run by Medicaid or an HMO with Kaiser.

I have lost some patients who have been with us for nearly 30 years. I am transferring records every day because people think they cannot pay cash for our services and instead are getting third-world care at Kaiser or they took Ambetter and cannot find a doctor or a hospital to accept them.

I lost our medical assistant because we could not, as a small group of three, find insurance for her that was affordable. Both the doctor and I are now on Medicare and my wonderful hard-working MA left for a big practice. And we should not fuss about ACA?  Any clue what it costs to hire someone through an agency? It would be several thousand dollars.

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We lucked out and re-hired a former employee, who happens to be on Medicare, and cut the days we see patients to four, so I do not have to pay her for 40 hours a week. I, the office manager, have taken on more of the paperwork that the MA used to do. It is 6 p.m. on Friday night and I am nowhere ready to leave. I take work home.

But I should not dwell on ACA? Those idiots in D.C. with their fancy cars and fancy lobbyist-paid dinners are killing small business. We get patients with HSAs who pay bills on those credit cards which cost us 2.5 percent of our discounted fees to run, we deal with those pesky deductibles which patients do not want to pay (thousands of dollars to collection keeps rising every year), and we do not perform fancy procedures in primary care ($17 for an EKG and the clerks at the carriers tell patients that the doctor should not have done one because it is not needed at a physical exam.). 

Mrs. M is in her late 50s but retired and now has Kaiser. Mr. H is a fragile diabetic and left for Kaiser. Mr. W, who came to us in the past two years and is finally under control, is now leaving. Mr. L has been a patient for 25 years; he is self-employed. Mr. R has Medicare but his wife is younger.

I could give you 100 names of our self-employed patients who managed to pay their bills in 2017 and did not leave us stuck with their deductibles. But now that ACA is gutted, they have left. Our cash prices are not bad but everyone who is wasting money on insurance feels they need to use the insurance. 

We should not dwell on ACA. What planet are you all living on? 

Sandie Berger
Marietta, Ga.