Americans are rapidly discovering the problems created by the massive federally controlled bureaucracy of the Affordable Care Act (ACA). Gallup reported that more than 50% of Americans want the law repealed or scaled back. Alternatives to this law have been offered in the past, but summarily dismissed. These need to be revisited.
The ACA was “sold” to America on the premise of soaring healthcare costs and lack of access to healthcare for many Americans. The initial positive public support was predicated upon the promise that “If you like your doctor, you can keep you doctor”, and “If you like your health care plan, you can keep your plan, period. No one is going to take it away.” Americans believed that those who needed assistance would receive it and that most families would see a $2500 reduction in yearly health insurance premiums. These guarantees were patently false.
The tragedy that is unfolding need not occur. Disruption of the private insurance market, resulting in millions of people losing their current coverage was not necessary. Because $700 billion was diverted from Medicare to pay for insurance exchange subsidies and expanded Medicaid programs, millions of seniors lost their Medicare Advantage Plans and along with this, their doctors. This did not need to occur. Millions of Americans did not need to lose their jobs or become part time workers because of onerous regulations imposed on businesses as a result of the ACA.
The Administration insists that these are “temporary” glitches with the federal exchange website. The problems are far deeper than IT issues.
The irony of this entire debate is that the people who know the most about delivering care to patients were excluded from the development of the ACA. The physicians involved in crafting the administration’s vision, such as Drs. Ezekiel Emanuel and Donald Berwick, were far removed from day to day patient care.
Claims that the only alternative to the ACA is a return to the "old" healthcare system is a "straw man" argument. Alternative solutions were proposed but have been misrepresented or ignored. American healthcare is the best in the world, and most Americans had been pleased with their insurance coverage. While problems do exist which have to be addressed, they need to occur with minimal disruption to those who are content with their
Those in Congress, who passed the ACA, were equally uninterested in the opinions of true experts in healthcare delivery- practicing physicians.
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