Print Article: America needs health care that works
America needs health care that works
By MARCY ZWELLING-AAMOT
Repeal of Obamacare has become a mantra of the new administration; one of many decrees to clean the proverbial swamp. Not so fast we hear from some in the GOP and the political left. And they’re probably correct to be cautious rather than cavalier and concentrate on fixing health care. Repeal gets us nowhere. It’s campaign rhetoric. The GOP needs to focus on a replacement that works to bring an opportunity for every American to purchase the affordable medical and health care that they need and want.
Passing the ACA settled the debate about a person’s right to health
care insurance and the GOP understands that. With the stroke of the president’s pen the nation shouldered the obligation of making sure patients are insured. The problem, of
course, is the law that Congress passed is only about insurance, not about care and it does not work.
The ACA is a finance system that offers a benefit package that is too expensive for most Americans even with the government subsidy. But more importantly, it does not allow access to health care. In fact, the ACA regulations and exchanges often stand in the way of care because of the narrow networks and paper work that are necessary to navigate before care is offered.
The nation’s physicians have found that in spite of wanting to be there for all their patients and signing on to the exchanges, they cannot find other professionals who have also signed on leaving them empty when it comes to consultations or further care. Imagine my personal frustration when I found a mass in my godson’s neck. The ultrasound was done immediately for $175 and the biopsy followed for $500. Within 48 hours we had a diagnosis of cancer with nowhere to go because the surgeon who I called does not take Obamacare and he needs surgery. In spite of calling his primary physician and giving her instructions on what to do, we’re still waiting (a week later) for the paperwork. He has no appointment with a surgeon or an oncologist. The system does not work. Like most government bureaucracies, process takes precedence over results. The GOP can fix things by replacing the ACA with a functional alternative.
Complete repeal of the ACA without a suitable replacement would be a disaster for the country and the GOP. If full repeal moves forward without a replacement, millions of insured patients would find their insurance to be even more useless than it is now as the narrow exchange networks will become vacuous.
The GOP would be wise to vote for a replacement that allows for the marketplace to repeal Obamacare “in effect.” Legislation repealing the individual mandate and the employer mandate would be a start so long as the legislation also replaces the current lavish benefit package that includes fertility care (even for males) with a minimal essential benefit looking more like a catastrophic only policy. That would be a signal to insurers to offer a panoply of plans with all kinds of benefit opportunities that encourage real competition. This legislation has been written and is ready to roll out. Rep. Pete Sessions, R-Texas, and Sen. Bill Cassidy, R-La., have worked for over 18 months with over 500 physicians from all over the nation to
http://www.ocregister.com/common/printer/view.php?db=ocregister&id=741090 Page 1 of 2
Print Article: America needs health care that works 1/25/17, 8)32 PM
construct a plan that works.
This legislation offers tax credits to every American citizen with generous HSA’s that allow the marketplace to effectively bury Obamacare as less expensive policies offering more choices would be available for purchase. No one would be forced to lose his or her insurance. Turning this entitlement into a defined contribution program rather than a defined benefit program would allow the federal government to calculate the yearly outlay and allow for a more sustainable entitlement.
The bill offers generous HSA opportunities. We will need to see prices publicly posted to encourage competition and accountability among physicians and health care facilities. Lower cost and higher quality will find their home in a competitive transparent marketplace.
Most importantly, it fixes the problems found with the ACA because patients and doctors will no longer be tied to useless paperwork but can work together on behalf of quality care. Supporting this focused legislation will allow the GOP the opportunity to become the champion of the hard working American family.
The health of the every individual living in this country is serious business. Their health is my solemn responsibility as their trusted physician. I am hopeful that our elected leadership can leave their egos at home and come together to pass a reform package that will allow America’s citizens to make their own choices about their life and their health in a marketplace where physicians are challenged to compete.
In the end, Americans deserve affordable health care. It’s within our reach if Congress moves forward with the Sessions/Cassidy bill and really fixes health care.
Marcy Zwelling-Aamot, MD FACEP is chair of the National Physicians Council for Healthcare Policy.
http://www.ocregister.com/common/printer/view.php?db=ocregister&id=741090 Page 2 of 2