When the Patient
Protection and Affordable Care Act (PPACA, aka ACA) became federal law in
March of 2010, there were many assumptions about what the law would and would
not do. As everyone kno…

When the Patient
Protection and Affordable Care Act (PPACA, aka ACA) became federal law in
March of 2010, there were many assumptions about what the law would and would
not do. As everyone knows, it has become known simply as “Obamacare,” because
President Obama was the one who wanted health care reform. Here are some
misconceptions about health care reform.

One of the first statements made was that the new law was
tantamount to “a government takeover of
healthcare.” For this to be true, the government would need to inform every
citizen that they were being enrolled in a federal healthcare program, sort of
like Medicare, which is a federal health care program for any qualifying
citizen or permanent resident over the age of 65. In fact, there is no federal
alternative to private health insurance today. Since most if not all health
insurance companies that were doing business in 2010 are still insuring
millions of policyholders today, it is safe to say that there has not been a government
takeover of healthcare.  It is also true
however, that many people would like to see that happen. They would love to see
Medicare expanded to include everyone; but that is very unlikely for many years
to come, if ever.

“Medicare benefits
will be reduced.” Actually the opposite has happened. Medicare now covers
annual physical exams and colonoscopies in addition to the quite comprehensive
benefits they have long provided. It is true that premium costs to Medicare
beneficiaries will go up in future years, but medical costs and premiums have
been rising steadily for decades, and seniors do use more medical services than
people under 65.

There will be
government “death panels” that will make end-of-life decisions for people on
Medicare. This idea was borne out of a well-intended provision in the
health care bill that would have helped pay for the end-of-life planning
discussion cost that the elderly already have with their physicians and
caregivers. So a good thing became a bad thing. Now there can be no provisions
in Medicare for this benefit which, ironically, hurts seniors and can actually
adds to the cost of health care.

Illegal immigrants
will now be covered. The ACA specifically prohibits undocumented immigrants
from receiving coverage.

What is not known is the true long-term cost of this
legislation. There are many people on both sides of the argument, time will
tell what the real cost will be, and there are many components of this program
still to be implemented. The truth about health care is that it is expensive no
matter where you are.  Canada, England,
France, Switzerland, Italy, China. 

All of these countries have some form of government provided
health care and while it is less expensive per-capita than in the United
States, it is expensive nonetheless. The common element of all health care
programs is that every citizen or legal permanent resident is covered. The cost
of care per person is far lower when everyone is covered.

What needs to be understood about health care is that every
person at some point will seek it out when they need it. Whether or not they
have health insurance is not a factor when there is a need for treatment. If a
person cannot afford car insurance they have the option of not driving, and few
people drive without car insurance. Not so with health insurance, and the
situation is made worse by the fact that uninsured people often ignore minor
medical issues because of the cost. Unfortunately those minor medical issues
have a way of becoming serious, and that is when the uninsured seek care. And
where do they go to get treatment then? The emergency room, which happens to be
the most expensive entry point into the entire health care system in the U.S.
They go there because federal law prohibits hospitals from turning away anyone
during a medical emergency.

This is a huge factor in the cost of health insurance, and a
major reason why health insurance premiums have risen far in excess of the CPI
over the past 30 years. Until that part of the health insurance equation is
resolved the cost of insurance will continue to be out of reach for millions of
Americans.

In summary, the cost of delivering health care in the U.S.
is not going to go away as an issue. The debate over the number of uninsured
and whether or not they should be covered, public vs. private insurance, and
who pays for all of this will go on until our politicians realize that there is
no one best solution.  All sides will
have to agree that there will always be some elements of a common health care
system that not everyone will like. 
There are many elements of the Affordable Care Act which work, and those
elements need to be preserved.  Many
insurers who initially opposed the Act have since re-tooled their benefit and
pricing models to reflect the major objectives of the program.  The irony here is that abolishing the ACA
would actually increase the cost of coverage as insurers once again had to
redesign their policies and coverage. 
What is needed most of all is a system that works reasonably well and
covers everyone or nearly everyone.  In
the long run, the cost of excluding millions of uninsured will cost more than
covering them. 

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