ACA “Obamacare”: Necessary Change or “Bigger must be Better”

Why I changed my mind this weekend,  … or …

Is the ACA all it’s cracked-up-to-be:   Is there more-than-meets-the-eye  ?

Does “Obamacare” actually address the real problems plaguing US healthcare?

Reform the failed system by making it even bigger?

Is Bigger always better ?

I used to believe that the US medical care system was seriously flawed to its core, placing Physicians onto pedestals previously reserved for the Gods, offering mostly ego and profit-driven poor quality care at exorbitant prices – a busted machine needing serious reform.

Then, I got briefly swept-up in the “Civilized nations really do take care of all their people” movement,  pumped up by Media and politicians huffing and puffing, swept along by emotional appeals from people caught in the whirlpools of a medical system begging for major overhauls,  with cure-alls promised by the Affordable Care Act (“Obamacare”).   On the heels of this Friday’s Supreme Court decision, I went back to do a little more research.

After reading some facts and facing the realities of those facts,  I moved beyond the emotional justifications that “We must have Obamacare, just because we must do something…”.   ?

As part of a thoughtful PBS analysis of the 40 million uninsured Americans, a top AMA official notes that:


“We certainly are in a health care crisis.
If we had set out to design the worst system that we could imagine, we couldn’t have imagined on as bad as we have. Here’s a system in which we spend over twice what the next most expensive country spends on health care — that’s Switzerland. We spend roughly $4500 for every American, whether they have insurance or not. Switzerland spends maybe $2500 for every citizen. Canada spends maybe $2,000. Great Britain, poor little Great Britain, spends about $1,000 for every British citizen. And what do we get for it? What do we get for that $4500?

Well, we certainly don’t get our money’s worth. …

Our life expectancy is shorter. Our infant mortality is higher. Our childhood immunization rate is lower. And look at how often we get to see the doctor, how long we get to stay in the hospital. Canadians see their doctors far more often than we do.

(Even insured) Americans really can’t afford to go see their doctor. There’s always some co-payment, some deductible, or they have to pay out of pocket, or something isn’t covered. But in Canada, where everybody is covered for everything, they go to the doctor much more often. When they are hospitalized, their hospital stays are longer.”

http://www.pbs.org/healthcarecrisis/Exprts_intrvw/m_angell.htm

Add in the facts that physician and hospital errors unnecessarily kill 125,000 US patients per year (a generally unreported major cause of death in the USA),  and then count the number of US patients permanently harmed but not killed by shoddy unacceptable US physician practices, and the casualty count grows to over 1 million fresh bodies ~ every year.

~~~~
This factual presentation took me back to points from 4 years ago:
The ACA ~ Obamacare ~ did not and does not address the major, very-real problems of the US healthcare mess.     The facts show that Obamacare is a sham that only pretends to “solve the problems” ,   while shaming us into believing that it is the “humane” thing to do – falsely presented as our only option.

Bad solutions do not fix  already-bad  situations.

Instead of forcing 40 million uninsured people into the already horrible – worst insurance system and poorest quality healthcare system in the developed world – we could choose to fix the real problems…

Obamacare has been declaring that:
Our house is on fire !

We must pour out more of our scarce water to put out the fire !…..

In reality, Obama caved into the Insurance and Physician’ lobbies and used the force of Government to pour water onto ~ a fallen-down house down the block ~ … while our own house continues to burn.

Wrong solutions applied to the wrong problems do not equal success.   More big $$$ rewards poured into the bank accounts of failed insurance and failed physicians industries sure is   what the Doctor ordered,   but it is not   what the patients need.

Obama has knowingly pushed a set of solutions that exacerbate the real problems – further bloating Physicians overly large salaries and Insurance companies over-bloated systems & profits… Obama gave the special interests what they wanted, while waving the banner of helping patients..

Look at the recent new wave of mergers and acquisitions driven by Obamacare, as “health-care” financial officers look forward to the huge new profits to be made after 2014, when the major parts of Obamacare actually kick-in.   These business guys spending $$billions are not fools. They know what’s happening, and they are busily carving up the new hunks of government mandated meat.

In the meantime, I and others have been temporarily duped by the emotion-mongers and Big Media hype.

A quick reading of the facts burned off the artificially generated emotional fog .

Stage fog pumped out by Washington politicians & Big Media and blown around by uninformed patients crushed by a failed system….

Reform the failed system or make it even bigger?

Again, I prefer pertinent appropriate facts and rational solutions that attack the real problems over hype and emotionality.

Real reform of US healthcare should not be sacrificed to create an Obama legacy of even bigger “More of the Same” systems.

*         *          *          *

Readers who are interested in practical solutions that provide excellent health care for all citizens at half the costs of the US, check out the Swiss system.   After studying every single national healthcare system on the planet, they   ~ learned from the other countries’ mistakes ~ and instituted the best national system by blending private    and    public approaches.

Forbes magazine has a good synopsis of how the Swiss blended private insurance companies and Governments to create a system that seems to offer the best care in the world, to 99.5% of their citizens, with short wait times to see a doctor, at costs that are less than half of the US per patient costs.  You can read the details of the Swiss system but you have to wade through a few introductory paragraphs.  Why Switzerland Has the World’s Best Health Care System

*         *          *          *

Feel free to copy while giving proper attribution: YucaLandia/Surviving Yucatan.
Steven M. Fry

Read on, MacDuff!

6 Responses to ACA “Obamacare”: Necessary Change or “Bigger must be Better”

  1. Pingback: ACA “Obamacare”: : Necessary Change or “Bigger must be Better” ? | Surviving Yucatan

  2. yucalandia says:

    Meridagoround originally made the following comments in our Flotsam and Jetsam article.
    Since the originally intended short observations on ACA – Obamacare grew larger than expected, we moved the ACA article out of Flotsam & Jetsam – and hence present Merida-go-rounds comments here:

    Author: Meridagoround ~~ Website: http://meridagoround.wordpress.com ~~

    “I agree with you, Steve, that a civilized nation should take care of the health needs of all of its citizens. But instead, the politicians on both sides, who have their own gold-plated care policy, have merely taken care of their big donors. The system enacted will unravel because it is unsustainable.

    Obama, whom I voted for ONCE, caved, first to Wall Street by appointing Summers and Geithner to “rescue” the economy they had destroyed; and then to Big Insurance and Big Pharma, allowing them to bleed the public.

    NB: the majority of pols dumped the single payer option quickly, even though that’s what the majority of first world nations use, because Big Insurance didn’t want to compete against the public group (potential gov’t plan) in the market place. And their PR agents invented histrionic language (“death panels”) to kill that single payer plan. Oddly, it was many of the same people who insist on austerity who shouted “death panels” — demanding ultra care, while refusing to allow any tax increase to pay for it. Dunno how to get there from here.

    Here’s the best assessment I’ve seen thus far:
    http://www.huffingtonpost.com/marcia-angell-md/roberts-romney-health-care_b_1637397.html
    ~eric.

  3. yucalandia says:

    A few after the fact observations on Solutions that Work and
    Alternatives that Do Not Fit:
    Many Americans and Canadians hold up the Canadian health care system as a valid alternative.

    I do not believe that copying the Canadian’s healthcare plans can work for the US, as Canadian healthcare is mainly paid for by the sales of their abundant natural resources. Because Canada is blessed with of a huge wealth of timber, diamonds, oil, fresh clean water, gas, agriculture etc, and a relatively small population, their model is unique and cannot be replicated in other developed countries.

    Continuing, typical single payer models of other nations are politically not practical for the US, since major blocks of US citizens vehemently oppose such Socialistic systems, and would not allow them to be enacted. Simple Senatorial fillibusters would never let them even go to a vote on the Senate floor, killing them.

    Instead, the US public would be well-served to examine the high-functioning Swiss system, that uses a group of private insurers to cover all citizens. Those companies COMPETE for enrollment, while containing costs. The Swiss carefully studied all other national healthcare systems on the planet, and after seeing significant flaws in all other systems, they chose to create their own model, and they have been refining it ever since.

    If we want to pay half as much, for much better care for all citizens, then the people of the US should demand that their leaders study and adopt what works – with adjustments to account for some unique aspects of America – and drop the current effort to force 40 million new subscribers into an already failing system.
    Dr. Steven M. Fry

  4. ReadingTerminal says:

    I confess that I have not studied all the world’s health care systems, nor do I intend to. Life is not that long! (Steve is much younger than I am.) Nor have I ever heard the Swiss cited elsewhere as a model for others. And I have tried to read Steve’s argument here, knowing he is usually well reasoned, only to find him doing a strong dance, back and forth, with the left and right sides of his brain at seeming war with each other. Thus, I really do not know how to process the sentence that includes that we should “drop the current effort to force 40 million new subscribers into an already failing system.” Force the uninsured to be covered finally? Is that really what is being said?

    As for the already failing system — and I advocate a universal health model, such as Obama never offered, but for that matter would never have passed the Congress — what is the real recommendation?

    Jonathon Chait, in the current New York Magazine, writes, in part,

    “If Republicans really wanted to replace Obamacare with some more “market-friendly” alternative, then there’s a simple way they could go about it. They could promise to repeal the law only if they packaged the repeal with a replacement that did not increase the number of uninsured. But they’ll never do that, because the magic, cheaper free-market alternative does not exist, and the GOP has no interest in diverting resources to cover the poor and sick.

    “{Hoover Institution’s Keith} Hennessey, who lays out the most specific vision for repealing Obamacare, asserts, “Repeal and replacement should be separate legislative efforts.” This means, of course, that the actual plan is first to get rid of Obamacare, then pretend to work on a replacement before eventually discovering that it’s expensive and unpopular. Oh well. The only interesting question here on any level is why so many conservatives feel bound to pretend that the Republicans really are going to formulate some other plan to care for the poor and sick.” ( http://nymag.com/daily/intel/2012/07/will-romney-pretend-to-have-a-health-plan.html )

    In the current US political climate, with the Republican surrender to the “Tea Party,” there is. alas, little chance of anything any better coming down the pike than the perhaps dubiously named Affordable Care Act care. Steve criticizes its surrender to the big insurance companies, but then suggests a Swiss model than includes private insurance schemes “competing” with each other. Up until now, the US has seen its insurance companies “competing” with each other in such ways as eliminating applicants with pre-existing conditions!

    As for the US being unable to match Canada’s current less than rigorous allotment of funding to health care, we spend an enormous amount, more per person than any other country in the OECD, and get less bang for the buck owing to the built in waste, starting with the insurance companies’ cut of the health care dollar. Given the unbelievably selfish accumulation of personal wealth by the famous upper 1% of US wealth, it boggles my mind to think that our society does not have the economic means to see to it that all have access to adequate and timely health care services. We just have to be smarter about how those resources are used, and more aggressive in cloying the extra bucks out of the hands of the super rich and their corporate tax evasions (including “shifting” profits off-shore). And for those who attempt to escape to tax havens, such as Barbados, Steve’s favorite Switzerland, or the Cayman Islands, strip them of their US citizenship, deny them access to the USA, and go after their foreign holdings.

    • yucalandia says:

      Good comments!

      There are reasons why various international health care policy analysts cite the Swiss model as likely the best working model in the world. Of all nationalized healthcare plans, Switzerland has the most recently developed plan ~ building on the best aspects of the Taiwanese, Japanese, and German plans, utilizing a very effective combination of centralized cost controls and centrally planned benefits, administered through a pool of their previously existing insurers. Their system gives better care, more physician visits, longer hospital stays, and better overall national health at half the cost per patient, which makes it worth studying. Describing the Swiss system is way beyond the scope of a comments post, so, I advise reading more about what actually works, rather than pushing 40 million uninsured into an already-broken US system.
      steve

      • yucalandia says:

        I realize that I left things hanging in the last comment, when I said that describing the Swiss system in a Comment. I did a little research to cover that marker:

        Forbes magazine has a good synopsis of how the Swiss blended private insurance companies and Governments to create a system that seems to offer the best care in the world, to 99.5% of their citizens, with short wait times to see a doctor, at costs that are less than half of the US per patient costs. You can read the details of the Swiss system but you have to wade through a few introductory paragraphs. Why Switzerland Has the World’s Best Health Care System

        Enjoy,
        steve

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