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 Gallup reported that more than 50% of Americans want the law repealed or scaled back.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.
Docs4PatientCare is an organization of practicing physicians, dedicated to the preservation and improvement of our excellent medical system, the sacred doctor-patient relationship, and affordable quality care for all Americans. In 2010, we published a Prescription for Healthcare Reform, which outlined the principles we felt were necessary to address the problems in our healthcare system. These proposals were crafted to deal directly with the underlying causes of the dysfunction inherent in the “old” system, while gradually transitioning to responsible and economically sustainable models.
Few physicians oppose reform. For decades, the debate has revolved around the “best” methods to accomplish these complex goals. This can be distilled into a single core issue- who is better suited to make healthcare decisions for patients; individuals with the assistance of their physicians or the federal government?
We have revisited and updated our Prescription. Successful reform needs to be non-partisan and must include the following principles:
1. Equal tax treatment of health insurance for all Americans.
2. Health insurance as true insurance, not a pre-paid health maintenance plan.
3. Individual ownership of portable, insurance policies not tied to employment.
4. Purchase of insurance and healthcare services in a true, competitive market, across state lines.
5. Government supported programs (e.g. Medicare, Medicaid & SCHIP) transitioned to fiscally responsible and sustainable programs by giving recipients the same consumer choice and market controls available to those who purchase their own insurance.
6. An improved medical malpractice system which provides fair compensation for injury while supporting quality improvement.
7. Health information which functions as other advanced electronic technologies, free of excessive federal government dictates.
8. States empowered as laboratories for new healthcare delivery models.
9. Physicians enabled to deliver high quality, cost efficient healthcare to patients free of burdensome, ineffective regulation.
10. Encouragement of charity care and physician participation in current low paying government programs through modified tax policy.
The full document is available in pdf form here…
This Prescription is not a plan, but a framework upon which legislation could be developed to make healthcare work for all Americans, and not just those whom the government chooses to support.
Hal Scherz is the President & Founder of Docs4PatientCare. He is a full time pediatric urologist at Children’s Hospital of Atlanta and a clinical associate professor of urology at Emory University.
Please visit http://www.docs4patientcare.org