Guest column: We can't afford the Affordable Care Act

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Guest commentary

I find the continuing events regarding the Affordable Care Act very troubling. I hear there are no better alternatives — and that simply is not true.

As one who spent 37 years in health-care leadership and understands the industry inside and out, I am compelled to write on one of the worst government debacles in our history.

I start by dispelling three popular myths about our current health care system that is used to justify the ACA.

First, it is said that we have the most expensive health care in the world and costs are out of control. Really? Based upon what? As long as Americans want the health care they want when they want it and get it, it will be expensive. Should we be denied that privilege by our government?

I have done extensive research on government-run health care systems in other countries and here is what they do to control costs. Diagnostics and treatment beyond primary care is limited; therefore, long waits are common. Medical services like joint replacements or heart surgery are not available to everyone, usually based upon age. Medical research and access to sophisticated equipment for diagnostics and treatment is limited. Due to lower incomes and government regulation, fewer students are going to medical school and access to even primary care is diminishing.

I just returned from Asia where it is touted to be much less expensive for the exact same hospital services in the United States. More than 50 percent of hospital costs are salaries. The average salary in Asia is far below that of our country; i.e., Vietnamese average $500 per month in “good” jobs. In Russia, truck drivers make more than physicians.

All of these other countries are continuing to experience increasing health care costs and are looking for new solutions. In many of them, the rich get care because they can afford it; the poor get care because the government pays for it; and the middle class is being financially squeezed out. So much for other countries controlling health care costs better than us!

Also, did you know that in the U.S., Medicare only pays providers approximately 85 percent of costs and Medicaid 60 percent of costs? That’s costs, not charges. This is a substantial hidden cost passed on to you by the government.

The second myth is that other countries have better clinical outcomes than we do. I would like to see a study that compares “apples to apples.” No other developed country in the world has our socio-economic issues with a significant percent of its population excessively vulnerable to health problems and who do not seek proper care on a timely basis.

The third myth is that millions of people do not have health insurance and cannot access needed care or they are forced to declare bankruptcy. I do not know of one person who did not receive the care they needed regardless of their ability to pay or ever had to declare bankruptcy. Hospitals and many physicians provide significant charity care for those who can’t pay and offer reasonable payment programs for others with limited funds and no insurance. No one ever hears about the multitude of free or discounted community medical clinics sponsored by private donations and government programs. This cost is already built into the system.

So, what are my alternate approaches to reduce costs? First, we need insurance plans such as health savings plans that encourage the consumer to make more responsible decisions in accessing health care and not demand what they want when they want it.

Second, we desperately need tort reform. Enormous cost is incurred by hospitals, physicians and medical suppliers paying unwarranted malpractice claims and clinically attempting to protect themselves from lawsuits.

Third, we need to improve legislation to promote and support living wills for end-of-life decisions based upon meaningful education and the patient’s personal desires and not pure emotion during a time of crisis. It has been estimated that 1 percent of the population accounts for 30 percent of health care costs, with most of that 1 percent being at the end stage of life.

I am not promoting euthanasia, but an educated and effective approach to living wills. I have personally been involved in family disagreements where the patient did not want heroic measures and family members insisted. This puts providers in a very difficult position both ethically and legally.

That is my three-pronged alternative to the Affordable Care Act.

The ACA is significantly increasing, not decreasing costs. People who liked their insurance coverage are now forced to acquire more expensive policies to subsidize people who are already adequately taken care of by the existing system, or those who choose to spend their money on material things rather than health insurance. It is estimated that more than 5 million policies have been canceled and possibly 85 million more will be when employer-sponsored insurance comes under the law. People are not only being forced to subsidize other people, they are forced to pay for services they don’t need such as dental and eye care for children they don’t have or maternity care when they are no longer of child-bearing age.

How about the billions of dollars being spent on implementation or the additional funding needed when young people do not sign up? Many new people are signing up for Medicaid. There is an estimated $500 billion in new taxes on citizens, medical suppliers and employers that will be incurred by all of us. This is reducing health care costs?

Oh, how about the committee that is being downplayed which is mandated by the ACA to advise the government on care restrictions like those in other countries?

The ACA would better be called the IUDHCA (Inflexible Unaffordable Destroy Health Care Act). I can guarantee you this law will not work and politicians will destroy the best health care system in the world implementing lame ideas trying to make it work. Is that what we want?

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