Archived Story

Obamacare: Maddening mistakes

Published 11:08am Friday, February 14, 2014

To say the Affordable Care Act has had challenges in its startup is like suggesting a hurricane is just a rainy day with some wind.

From the websites early failures to this week’s delay of small business implementation, mistakes have continued to plague the launch of this important legislation.

But how did we get here?

The U.S. had perhaps the most dysfunctional health care system of any developed nation. Seven US presidents tried to fix the maladies connected with the chaos that was American health care with no success.

The system was at odds with itself at virtually every juncture. The insurers, operating to maximize profits, could only do so by minimizing care. That meant no plan for preventative care that reduces long-term care because profits are measured more by short-term results than long term commitments. Profit also meant refusing to insure those who might need insurance the most and cost insurers the most.

The hospitals were conditioned to treat the uninsured through emergency services that are billed at the highest tolerable price. Hospitals then raised the costs of all services to transfer the costs of charity care to paying insureds.

Hospitals also were more profitable when readmissions were frequent and comparable costs at other institutions were not measured. In short, the hospital community had absolutely zero incentive to reduce costs.

Doctors were paid for procedures completed instead of outcomes, so they were encouraged by the system to order a maximum number of tests, blame litigation, and profit from each test ordered with every visit to report on those tests.

Medical equipment providers created an industry rife with corruption, where markups were in the range of 1000 percent on equipment provided patients who had coverage.

With all of these profit structures the outcome was the most expensive, least effective, healthcare system on the planet; a system that could provide anywhere from world class care to no care for those who became uninsurable.

From this Obamacare was born.

Certainly, there needs to be an appreciation that the good parts of Obamacare are gains we will never surrender. From millions insured to the age of 26 on their parents insurance, to preventive care and free testing, to no lifetime limits on coverage or cancellation for severe illness, the ACA has already made American health care better.

But the ultimate test is not about a website that malfunctioned for 45 days; it is about converting the American health care industry to one with full access, responsible contributions by those receiving care and preventative care with a “best practices” approach that bends the cost curve downward.

That all may happen, but the delays have caused many Americans to question if these outcomes are going to be realized in the near future, and to wonder if the administration is playing politics with implementation.

This week, when President Obama delayed another key component of the ACA until after the November’s elections, the timing struck many as questionable at the very least.

What should have happened, and did not, was a clear and understandable explanation of why the delay was necessary, in terms that eliminated the question of political motivation.

Obamacare is not going to be reversed, and those studying it know as much. There is no putting this Genie back in the bottle.

But sooner rather than later progress needs to become predictable and implementation needs to rise to nearly seamless status.

The interim period, filled with maddening mistakes, needs to be over.

 

Jim Crawford is a retired educator and political enthusiast living here in the Tri-State.

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  • mickakers

    79Tiger; I enjoyed your comment (use of words), not saying I completely agree with your comment, only partially.

    (Report comment)

  • http://www.tytandan.com 79Tiger

    We don’t want to put the Genie back in the bottle, we want to eliminate the Genie. It should have never been allowed to escape to begin with.

    (Report comment)

  • mikehaney

    Obamacare; paying doctors along the scale of medicare, will destroy our health care system as we know it.

    (Report comment)

  • mikehaney

    crawford–That all may happen, but the delays have caused many Americans to question if these outcomes are going to be realized in the near future, and to wonder if the administration is playing politics with implementation.

    This week, when President Obama delayed another key component of the ACA until after the November’s elections, the timing struck many as questionable at the very least.
    ————————————Politics? Obama has no clue. He is just a good yes mam. When is his next vacation to Hawaii?

    (Report comment)

  • mikehaney

    Crawford.-But the ultimate test is not about a website that malfunctioned for 45 days; it is about converting the American health care industry to one with full access, responsible contributions by those receiving care and preventative care with a “best practices” approach that bends the cost curve downward. ———————–Talkin death panels here

    (Report comment)

  • mikehaney

    Certainly, there needs to be an appreciation that the good parts of Obamacare are gains we will never surrender. From millions insured to the age of 26 on their parents insurance, to preventive care and free testing, to no lifetime limits on coverage or cancellation for severe illness, the ACA has already made American health care better. ————-
    Train wreck not needed to fix above.

    (Report comment)

  • mickakers

    Jim Crawford; Our Health Care system, including Obamacare, is a complete fiasco. Health Care is not a business but a basic human right and should be treated as such. We are the only major country in the world that fails to recognize this fact. All major countries have Socialized Medicine or a One Payer Plan (a term that is more politically expedient to use). We have become a nation of followers. We are easily misled. The Insurance, Medical and Pharmaceutical industries by their lobbying efforts have been deceiving the American people for years. We swallow what they say, hook, line and sinker.

    (Report comment)

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