Health care reform: Keep or repeal?
Pro: Affordable Care Act would reduce deficit, strengthen Medicare, raise oversight
SEATTLE – Many observers contend November’s midterm election was about the need to rein in our national deficit and to get the economy on the right track. However, when the 112th session of Congress convenes, the new Republican leadership will support a bill that will: increase the deficit by almost $150 billion, increase the number of people at risk of bankruptcy, repeal a $110 billion middle class tax credit and weaken Medicare’s solvency.
I’m talking about the overt Republican strategy to repeal the Affordable Care Act (ACA), the landmark health care reform measure enacted in 2010.
Despite their failed efforts to thwart this legislation with warnings of phantom “death panels” that are nowhere to be found and a supposed “government takeover” of health insurance that, in reality, is the largest expansion of private health insurance in our history, Republicans are determined to repeal this transformative measure.
Before they do, they should realize that repeal of the ACA will have far-reaching and detrimental ramifications for our health-care system and for our economy in general. According to the nonpartisan Congressional Budget Office, the reform law reduces the national deficit by $143 billion. It also extends the solvency of Medicare by 12 years, from 2017 to 2029.
If they repeal ACA, how will the Republicans justify increasing the national deficit and risking the financial stability of the Medicare program? I wonder what I will hear. I doubt I will hear that millions of hard-working middle-class families are not worthy of a tax credit to help buy private health insurance. I doubt Republicans will say 4 million small businesses – around 84 percent of all small businesses – should not receive a tax credit if they offer health insurance to their employees.
And House members of all political stripes have publicly supported the new Patient Bill of Rights included in the ACA, which among its other important protections ends the insurance industry’s practice of “cherry-picking” only healthy enrollees while denying coverage to sicker, more expensive patients.
Further, the ACA brings crucial transparency and oversight to the health insurance landscape. Nearly every state now is receiving federal assistance to review the out-of-control insurance rate hikes that force so many people out of coverage.
A Republican-led Congress passed the Medicare Prescription Drug benefit in 2003; this legislation gave millions of older Americans access to low-cost drugs, but it prohibited the federal government from negotiating favorable prices for those drugs from their manufacturers, so it added $500 billion of borrowed money to our debt. But that $500 billion balloon didn’t bother the deficit hawks.
On top of that, it created the “doughnut hole” that left many seniors without drug coverage just when their medicine costs became most unaffordable. The ACA gradually and permanently closes the doughnut hole, and provides drug discounts to seniors in the meantime – without adding one cent to the deficit. The Republicans know this, but in their zeal to repeal ACA they appear not to care.
As a physician, I long for the day when American health care professionals finally can focus on providing the best health care to their patients and not on the endless bureaucracy of the insurance industry.
I’ll just note here that the ACA has been hailed by physician and hospital groups for administrative simplification that will drastically reduce the nonclinical time providers spend on paperwork.
The ACA is a first, but crucial, step toward the cost-effective, high-quality health care Americans need and deserve. I sincerely hope the heated repeal rhetoric becomes instead honest dialogue. Once we stop campaigning, we can make an enormous difference for the betterment of our society.