Health gridlock: Another view
In the “Viewpoints” section of the Oct. 8 Ledger-Transcript there appeared several articles on the impact of the Patient Protection and Affordable Care Act (ACA), euphemistically called “Obamacare.” The third article in that series by Robert Wilkins on the political aspects of the ACA contained a significant amount of misinformation.
Mr. Wilkins asserts that President Obama exempted Congress and federal staffers from Obamacare. This myth has been debunked many times (see PolitiFact.org) yet it persists among those opposed to Obamacare. The confusion traces back to wording in the so-called Grassley Amendment. In fact, Congress and their staffers are required to participate in the health care exchanges.
He also claims that “Unions – a liberal constituency” want exemption from Obamacare. While it is true that some unions are concerned that Obamacare will “undercut” healthcare for their members, “they largely remain supportive of the Health Care law” (Politicfact.org). Congress, big business and unions have not been granted permanent exemptions as implied by Mr. Wilkins.
Mr. Wilkins goes on to make many unfounded assertions about reimbursement to “physicians, hospitals and other care facilities.” He is confusing several different program rules in these statements and it is difficult to tell whether he is discussing Medicare, Obamacare or some combination. Medicare reimbursement rates have been set by automated budgetary algorithms which are often inaccurate and outdated. This is why Congress is repeatedly faced with the so-called “doc-fix” to ensure that the reimbursement rates reflect current costs. In fact, Obamacare attempts to change the provider paradigm from “fee-for-service” to an outcomes-based reimbursement where better outcomes can lead to increased provider reimbursements.
Mr. Wilkins makes the assertion that “consequences include doctors limiting the number of Medicare patients they accept...” This statement, often made in the context of Medicare, is a scare tactic that has been around for many years. The New Hampshire State Committee on Aging addressed this and other questionable assertions about Medicare and Social Security in a fact sheet which can be found at www.dhhs.state.nh.us.
He further alleges that “increased control of the federal government will result in patient-related information being released.” This unreferenced statement has no basis in fact. He goes on to say that “Only patients’ physicians can judge what is best care for a patient – not an impersonal government regulator.” While the statement is true, the implication that “a government regulator” will make medical decisions under Obamacare is patently false. The law is designed to make sure that neither government regulators nor insurance clerks are inserted into the doctor-patient relationship.
Finally, we continue to hear the drumbeat that “President Obama does not care that a majority of the country is against his signature piece of legislation.” The statement is simply not true. We the people elected Barack Obama to the presidency, not once, but twice. The latter election was partly a referendum on the Affordable Care Act. Further, in nearly every poll on the ACA, approximately 16 percent of the respondents did not like Obamacare because it doesn’t go far enough. Recent polls show clear opposition to defunding Obamacare — 56 percent want to make it work while only 38 percent support defunding (CBS News/NY Times and Kaiser Family Foundation). More than 70 percent disapprove of the idea of linking the government shutdown to the ACA.
We the people have spoken loudly and clearly. The Affordable Care Act is the law of the land. It does present challenges — let’s work together to make it better.
Russ Armstrong of Peterborough is a veteran, a retired businessman and past chair of the NH State Committee on Aging.