I feel as if there is a sense of desperation and confusion in the air over the Affordable Care Act. Troubles continue to loom for the President and Democrats over what we can all agree was an unsuccessful “roll-out”. Concept good, roll-out bad. We’ve seen website glitches, repeated changes in the law and constant movement in deadlines. Remember, “if you like your doctor, you can keep your doctor”? On the other side, the Republicans distracted by their own vision, voted over 50 times to repeal the ACA and the dozen or more alternative plans proposed by the party haven’t mustered up the support, even from their own people, needed to make any real change or refocus the discussion in any useful and productive way.
We’ve been hearing about a universal healthcare plan for the nation since the Clintons were in office. I remember working for MTV’s Choose or Lose campaign and covering the elections at the time. Healthcare options came up and was debated and discussed in our town hall meetings. Our viewers loved the idea but no one seemed ready. The Clintons tried, but the push back from voters was so strong it became too hard politically to get any legislation passed. It wasn’t the right time. There has always been an obvious need to fix a system that became broken a long time ago. Recognizing this need, Medicaid was created in 1965 in order to provide healthcare for low income families. In 1986 the Emergency Medical Treatment And Labor Act (EMTALA) came out of Congress. The law was enacted to provide emergency medical services to all regardless of the ability to pay. It was a significant at the time to combat “patient dumping” which became so prevalent. And lets face it, morally wrong. Historically we have tried but have fallen short.
There are some serious problems that we can all agree on and I think we need to focus on these issues and fix them. Nobody should ever go bankrupt because they can’t afford to pay their medical bills. There should be a safety net built in somewhere in our system to help protect us from this happening. It is sad and disgraceful to see the people in “Sick In America” have to go through what they did to stay healthy and alive. Another issue is that everyone with a pre-existing condition should absolutely be accepted for healthcare coverage. We as a nation need to show more compassion for those that are sick and in need. This isn’t the time to turn our backs but a time to help lift them up. Respecting our own people in this way could create a climate to help others and continually set the tone to solve future problems. Another issue is why are administration costs so high in this country? Taiwan is at 6 or 8% while we are close to 25%. How does this happen? How are insurance carriers able to pilfer our pocket- books? Why does everything cost so much? One reason is we need major tort reform. Doctors perform tests and do procedures that are not needed just to cover their you-know-whats. But that’s another story. The main reason costs are high is there is an inefficient delivery system. We saw that topic come up quite regularly in the Frontline documentary. Too many rules, too many companies involved and too much to process. We pay too many people in order to administer the system.
Here are the reasons why I think a national healthcare can’t work in the US. We don’t require everyone in the country to participate. If you remember in “Sick Around The World” every single citizen of every country was required by law to participate. The success of these programs were directly linked to the fact that they mandated 100% participation. How could we require 320 million people in the US to take part? Our population is too large to enforce it. My belief is, if everyone thought it was the best for them and best for their families then they would participate. But they are not. Even our own professor opted out after weighing her options. I opted out. After my premium went up 22% in December I tried to shop in the marketplace. I was excited to have the option – single mother, limited income, student…where else could I find better. What I discovered is that I will pay more and sacrifice my coverage. It didn’t work for me.
This country was founded on an entirely different culture. We are not Europe, or Asia. There are too many that don’t trust the government to run anything right. Like the people of the U.S., the Doctors and businesses will always fight back when someone tells them how much to charge, how much to pay, where to buy, who to see etc. You get my point. Can you picture our doctors consulting a printed price book to see what to charge like they do in Japan? I can’t. When Senator Pelosi tells us, “we have to pass the healthcare bill so you can find out what is in it.”, people are just going to be skeptical. Does she really think everyone trusts the government that much? (Click on the link to see a great interview with David Gregory from Meet The Press. He asks a lot of good questions. And Pelosi has some good comments regarding intentions and what is the goal for ACA.) But getting back to topic, you can’t just tell Americans that they must do something. It needs to be a choice. When you take that choice away then it will never work properly. So when you are dealing with a public that is steeped in the belief of freedom of choice then lets present to them a plan the right way. Don’t rush the implementation just because all the political streams came together. Right now close to 60% of Americans disapprove the ACA. Not one Republican senator voted in favor of the ACA. Give the people what is necessary to be a healthy prosperous nation – lower premiums, lower healthcare costs, accessibility for all. Far too many mistakes were made here and now we are not getting what we need. Lets get it right.
Sarah,
This is an excellent post. You have identified and clearly outlined the issues, the problems and the debates. Very well done. When we started the development of the ACA, everyone was in the room and involved in the discussion Everyone had input. The problem, I believe, is that when you make change this massive in a system of politics and democracy such as ours it is always messy. We have started down a path and it will be interesting to see where we end up.