Let me describe myself: I am a 64-year-old white man, a self-employed master metal crafter, am very involved with my community, and have lived on the Central Coast of California since 1965. In a way, which I will explain, I am a poster child for the dysfunctional insurance system in the U.S.
Twenty-five years ago, I was diagnosed with a hiatial hernia. My primary physician said it was no bigger than the tip of my little finger and advised me "not to mess with it." When Blue Cross found out that I had "refused surgery," they canceled my policy. At that point, with a pre-existing condition, I could not buy any reasonable insurance. I spent the next couple of decades paying cash for the episodic check-ups and using the emergency room if something serious came up.
When the Affordable Care Act (ACA) was put into law, I applied for and was granted really great insurance through the Covered California program, and we started catching up with my health issues. First, it was a major surgery as my "tip of the finger" hernia had morphed into my entire stomach resting behind my lungs. Then, June 2016 brought a Stage 4 prostate cancer diagnosis, and with the help of UCLA Oncology, my very good urologist, my paid out of pocket naturapath, and a radically altered diet, I am now in remission. Thank God for the ACA! I am back to my production of fine metal products!
I've done a little digging and have found some statistics that if shifted would go a long ways toward actually making America great again. Here are just a few:
• According to The Lancet, the U.S. pays $9,237 per year, per capita for its health care.
• According to Deutsche Bank Global Markets Research Reports, the closest nation in the industrialized world pays just 44 percent of that figure annually, Australia.
• The Kaiser Family Foundation says that the U.S. ranks 12th in life expectancy among the 12 most industrialized nations. We are dead last ... !
• The New England Journal of Medicine states that the U.S. ranks 37th globally in the performance of their health care systems. We are ranked 39th in infant mortality, 43rd in adult female mortality, 42nd for male mortality, and 36th for overall life expectancy.
This is not a great report card.
I wonder what you are doing. I wonder what you hope to attain by repealing and replacing the system that has saved my life, as well as millions of others. Your efforts spanning seven years remind me of some classic literature, and I would invite you to climb down from your steeds, put down your lances, and stop jousting at windmills. It's embarrassing for all of us, and it is eroding your party's stature. The ACA is flawed, no doubt, and a logical response to that would be repair, not discard. Refine, improve, not repeal and start from scratch. Your repeated attempts to void a facet of the American social fabric in the face of the majority of Americans being in favor of what you wish to repeal, seems comically adolescent.
What are you doing?
If it is that important to chalk up a win, change the name of the system so you can say you got rid of it. A pundit I read suggested the other day that we re-name the ACA Ivanka Care. Cute, and I don't care. Do what you need to do to get past this. I do wish that you will stop this theatrical crusade, and get down to crafting and supporting bills, agendas, mandates, laws, edicts, whatever those instruments are called, that truly help all Americans, legitimately lift all boats.
In that light, I offer some suggestions:
• The U.S. is headed toward a single-payer universal health care system. Let's take our balky, antiquated system into the modern world and encourage that shift. Per capita health care costs will plummet, more people will be insured, health levels will rise. Insurance companies, facing disintermediation, are heading down the same path as film developing labs or Sears. Lets make sure that this industry's workers have a safety net.
• Put controls on the cost aof pharmaceuticals. Regulate the profits, and offset the industry's income loss by a surge in government-funded research labs whose work is open sourced. Use the savings in drug costs to advance American university research and not for profit lab research.
• Institute a medical industry oversight committee system to adjudicate malpractice cases, appealable to the established court systems; reform how court costs might be assigned; and establish a system of responsibility that raises the bar on the legitimacy of a court case. I know that Tort Reform has a bitter taste for many people; malpractice insurance should not be the biggest section on a doctor's overhead cost pie chart. Perhaps we can introduce disintermediation into this small facet of the legal industry.
• Lastly, (for now) and certainly not of the least importance, institute a slow and steady shift from our current system of test- and procedure-based compensation for our doctors and clinics, to one of a health index, a performance-based system. A shift to a care/result culture from a consumer-based compensation system. We get improved health and reduced time and money outlays.
I guess I'm asking you to abandon your fealty to your financial masters, and embrace what our Founding Fathers envisioned, a government that consists of elected citizens that represent and defend the rights of their constituents, their fellow citizens. A less lofty and perhaps more pragmatic approach might be to vote and enact legislation that truly reflects the wants and needs of the vast majority of U.S. citizens. We still vote, and your voters will remember your actions regarding their family's health care, whatever those actions reveal.
Please don't abandon us. Δ
Allen Root from San Luis Obispo is all about health care reform that benefits the people. Send comments to email@example.com or write a letter to the editor and email it to firstname.lastname@example.org.