To The Daily Sun,
Recently Hillary and Bernie stated they helped to write the Obamacare act — the Affordable Care Act. Here are some of the serious flaws they neglected to include.
1. The acceptance of inequalities — what is considered "essential coverage" is ambiguous — not the same for all — subject to definition by the Secretary of Health and Human Services.
2. Insufficient and misguided attempts at cost control.
— Lack of tort reform. A few pilot programs set up to fail because they allow people to sue if they wish, and as they do now — a source of expensive, defensive medicine and costly malpractice insurance.
— Cuts to Advantage plans for seniors will result in a lesser benefit and/or higher premiums.
— Insufficient ''taxes" on drug companies and manufacturers of medical devices — these sources of costs continue to rise faster than inflation and increases in GNP.
— Too small a fine to make mandated purchase of insurance work.
— Emphasis on cost threatens to reduce certain kinds of care.
— A committee appointed by the president has as its mandate to make proposals to slow growth of Medicare. Their proposals are put on a fast track, limiting debate and amendments — have to be within the mandate - 30 hours of debate and that can be cut off at any time.
3. Measures that will drive up costs of Medicare
— A call for expensive screening for seniors to be paid for without deductions — given present medical practices this will lead to over-treating and over-medicating. The government will also pay to advertise the "benefits" of screening — CT scans greatly increase the risk of cancer, an expensive outcome.
4. Measures that will drive up costs of health care generally
— Establishment of 36 centers, boards, commissions, committees, etc. These cost money.
— Much money to be spent on administration and oversight. The secretary of HHS will need a much larger staff.
— Government will pay for "federal faculty" (so-called) — salaries at premier medical schools — government curriculum.
— Number of research grants and grants for training — secretary of HHS has considerable power to fund "as necessary."
5. Too much power vested in the secretary of HHS. There are no fewer than 413 major initiatives that include criteria (even measures of what constitutes quality care), establishing the 36 boards, centers, committees, commissions, etc. (These) often determine what funds are "necessary" and for how long.
6. Too much uncertainty — all the discretion the secretary of HHS.
— How much all the grants, regulations, increased staff and 36 entities will cost is quite beyond estimation, never mind the federal faculty and the greatly increased screening and resulting increase in medical intervention of dubious merit (there will be many false positives). In short, nobody knows what the act will cost.
7. Increased demand for services will increase what is already a serious shortage of primary care physicians especially, but also of all caregivers. The prospect of adding more physicians is very poor, impossible in the immediate future.
8. No meaningful way in which this act will prevent the imminent insolvency of Medicare and Medicaid. (To avoid cuts in providing care, it is necessary to have drug companies and manufacturers of medical devices share their enormous profits with patients — the traditional way in which medical costs were paid — it is the Hippocratic ethic. The act does not recognize this ethic.)
Do we really want either Hillary or Bernie to write another Affordable Care Act?
- Category: Letters
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