Bob Jentges’ May 8 My View strikes me as being like a football coach trying to frighten players into quitting when the game has barely begun. His wholly negative piece reads like a catalog of scare tactics.
The Affordable Care Act is complicated because health care (18 percent of the economy) is complicated, whether in the public or private sector. Decisions are necessary that set standards, establish fees, include periodic re-evaluation, and provide infrastructure for every prescription drug, medical procedure, health care service, medical device, and item of medical or health care information occurring in homes, doctor’s offices, clinics or hospitals and nursing homes.
The ACA presents problems to overcome. But let’s remember: We’re the U.S.A. We established Social Security and Medicare, built the interstate highway system, and landed astronauts on the moon.
Here are 26 reasons for supporting the ACA that Jentges ignored:
1. Coverage for about 30 million people without insurance who will now be able to get coverage (30 million more reasons?)
2. Insurance companies no longer being able to refuse insurance to persons because of pre-existing conditions or to drop their coverage when they are ill (based on technicalities).
3. No annual or lifetime cap on coverage by insurance companies.
4. Young adults now able to stay on their parents’ insurance policy until age 26.
5. Health insurance exchanges with the opportunity to compare policies based on standardized essential benefits.
6. Lower cost preventive care for seniors, with gradual elimination of the “doughnut hole” for prescription drugs.
7. Subsidies to help provide employee insurance coverage for employers with fewer than 50 employees.
8. Subsidies to low income persons to enable them to get health insurance.
9. Improvements in the number, distribution, education, and training of health care workers.
10. More financial support for home health care.
11. New rules for eliminating fraud and waste in Medicare and Medicaid programs.
12. Support for a transition to outcome based payment systems as a replacement for fee for service payments.
13. Support for more coordinated health care.
14. End of higher premium costs for women.
15. Greater health provider transparency.
16. Expansion of Medicaid coverage to include more low-income people.
17. Elimination of co-pays for some types of preventive care.
18. Support for a shift toward electronic record keeping, coordinated care through “medical homes,” and outcome based payment methods.
19. Annual rebates from health insurers, if they spend less than 80 % of their income in providing actual health care.
20. Insurance exchange competition among private insurers and expansion of coverage groups.
21. Lower hospital costs, since they don’t have as great a burden for unpaid emergency room services.
22. A Medicare Independent Advisory Board to make recommendations if rising costs get out of hand.
23. A patient-centered outcomes research institute so health care workers have better information about best practices
24. Pilot program to explore alternatives to tort legislation.
25. More preventive care services for already established programs.
26. The cost benefits of greater preventive care and earlier treatment for newly insured persons.
Don’t let Jentges being miffed about “21 new taxes” distract us from the fact that there’s a way of paying for the ACA. Perhaps he would prefer a simpler taxing system like Medicare for All. But we weren’t able to get that.