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‘Obamacare’ benefits everyone

By Jay MacDonald ·
Friday, January 13, 2012
Posted: 11 am ET

This March, the Supreme Court will hear arguments on the constitutionality of the Affordable Care Act, which for the first time will require all Americans to obtain health insurance two years from now under a provision called the individual mandate.

If the nine justices rule that the individual mandate is unconstitutional, those 26 states challenging health care reform will urge them to take the next step and scrap the rest of the Affordable Care Act as well.

I'm a big fan of President Obama's historic health care reform. Without it, health care's ruinous fee-for-service paradigm that has hijacked patient care in the name of profit could very likely drive our economy off the cliff.

The individual mandate would insure an additional 30 million Americans, some with the help of government subsidies. Since we're already essentially subsidizing the uninsured who are forced to use places such as emergency rooms as their primary care provider, reallocating tax dollars toward their preventive care seems to me far more humane and sustainable.

I understand that being forced to purchase health insurance rubs many Americans the wrong way. Should the Supreme Court agree with them, so be it.

But before they toss the baby with the bath water, I hope the justices will consider the benefits that health care reform is already providing to millions of Americans. For example:

  • 2.5 million young adults have been allowed to remain on their parents' health insurance until age 26.
  • All Americans who enrolled in a health care plan after Sept. 23, 2010 now enjoy access to free preventive services, including cancer and cholesterol screenings, mammograms, colonoscopies, flu and pneumonia shots, vaccinations against measles, hepatitis and meningitis, blood pressure checks and nutrition counseling.
  • 20.5 million Medicare recipients reviewed their health status at a free Annual Wellness Visit or received other preventive services with no deductible or cost sharing this year.
  • 1.8 million Medicare recipients received a 50 percent discount on brand-name drugs in the Medicare Part D coverage gap known as the "doughnut hole" in the first nine months of 2011.
  • 4 million small businesses are now eligible for tax credits of up to 35 percent to help cover their employees. The credit jumps to 50 percent in 2014.
  • Your health insurance company is now required to spend at least 80 percent of your premium (85 percent for large employer plans) directly on your care and well-being or rebate the difference to you beginning this summer.
  • Americans with pre-existing conditions can now obtain coverage through a pre-existing condition insurance plan.
  • Insurance companies can no longer place lifetime dollar limits on essential benefits for policies written after Sept. 23, 2010. Annual dollar limits will be prohibited beginning in 2014.

I hope the individual mandate stands. I want all Americans to have access to health care coverage. Don't you?

But even if it doesn't, by what logic would anyone undo all of the good listed above?

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March 10, 2012 at 5:42 pm

What is the big deal?

Go to an emergency room in any town, big or small. If you could talk to the staff and they were able to share the information with you, (which they won't and quite rightly so) they would tell you that, irregardless of the affluence of the community, a substantial portion of the patients who come through the door are there for non-emergency treatment, and that many of those do not have any way of paying for their treatment.
Who pays for that medical care, delivered in a fashion which is totally not appropriate? You and I do. An ER is way overkill for a primary care environment, like taking your Toyota to a Nascar garage for an oil change. But the ER cannot turn you away if you can't pay, so that's where these folks end up. Now then, if they have to buy health insurance, even if they are subsidized for the cost, well, guess what, maybe they will just go to the doctor and save the ER for it's proper role. Sure we will all help pay for that insurance I guess, but who is paying now?
The hospital treats the patient. The patient can't pay. The hospital tries to bill some governmental agency to get their money. That is taxpayer money and that's us!
Hospitals do not get reimbursed quickly or appropriately for those expenses, some have to close or merge or cut back services. The population is getting older and instead expanding access to healthcare facilities we end up shutting them down.
Sometimes hospitals go under due to mismanagement but most of them do so because they are loosing money. Why, because they supply services and do not get paid for them! But if everyone had health insurance...sounds like a win/win situation to me.

March 10, 2012 at 3:46 am

One other point no one seems to recognize: Just how is it we convince someone to subject themselves to 4 years pre med, 4years med school, then 4-5 years residency, go into massive debt , work 70 hour weeks, all under constant threat of a lawsuit, for 80k per year?
Now you see why primary care doctors will be replaced with nurses with less than half the education and training. We can't afford docs on the front lines anymore. Expect a big PR campaign from CMS on the Wonderful Nurse Practitioners that are about to take over primary care. They will deluge Medicare recipients with this just before they send out letters in 2014 saying " You have been assigned to ----- Accountable Care Organization." I watched on C Span just after ACA was passed when CMS bureaucrats were discussing whether ( believe it or not) And then how they would break the news to Medicare recipients. Over the next few years almost everyone will be forced into an ACO because premiums will skyrocket under the weight of all the mandates. We won't be able to afford anything but an ACO. This was the Democrats plan all along. Read the bill.