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January 12, 2013

Obamacare won't cure what ails our system

Guest Commentary
The Daily Star

---- — The United States has a crazy quilt of healthcare systems and a patchwork of reformists’ regulations, and statistics say they have been an expensive failure.

The World Health Organization rates our system 37th for quality. We spend far more per person for healthcare than any other nation. They just announced health costs are 17.9 percent of gross domestic product — and we have shorter life spans and higher infant mortality than most developed nations.

We have socialist healthcare systems for veterans and Native Americans (that is, government-run healthcare). We have a single-payer system for the disabled and the elderly (that is, government-run health insurance). We have 50 different menus of health financing for the very poor.

We have adversarial workers compensation systems for those hurt on the job. Many big employers run their own health insurance systems. Many others buy group plans from among the 1,500 insurance companies. Some individuals buy their own plans. We have some charity clinics, public-health agencies, and school nurses. We have FSAs, HRAs, discount cards, and tax deductions.

The healthcare we get varies dramatically as does “coverage.” Each state regulates some aspects and the feds regulate others. And yet, as 2011 Census Bureau numbers show, 48.6 million Americans didn’t have any health insurance. That’s about one of six Americans.

Enter Obamacare, the misnamed Affordable Care Act. State and local governments are in a frenzy of making new rules and reforms. The signs so far this winter don’t look promising.

In December my spouse and I received a check of $58 from our “insurer,” United Healthcare/Oxford, because of a provision in Obamacare that limits how much insurers can keep for their overhead and profits. Not including co-pays and deductibles, we paid $4,700 to the insurer and my spouse’s employer paid another $21,300. The “insurer” doesn’t have any “in-network” specialists within 60 miles of my home. I guess we can use the $58 to eat out in NYC after we visit the doctor there.

This newspaper recently reported that our governor was crowing about our state’s new regulatory agency’s decision to limit health insurance increases to an average of “only” 9.5 percent in the “small group market” (individuals and most employers). That’s more than 5 times the current rate of inflation (1.8 percent) and 2.4 times the national average increase in health care spending for 2011 (3.9 percent). In many states, rates aren’t regulated at all, and they’re getting socked even harder. In California, Anthem Blue Cross just announced that they are raising rates 26 percent this year.

The Congressional Budget Office estimates that 26 to 27 million people will still be uninsured in 2019 when Obamacare is supposedly fully implemented. That’s roughly equal to everybody in New York and New Jersey combined.

Even before Obamacare is in full force, politicians are already eliminating some of its better provisions. Most Democrats, many Republicans, and the president decided to eliminate its long-term care coverage as a New Year’s gift. In the same law, they gave $46.1 billion in handouts to corporations over 10 years. About a third of states are considering refusing to raise Medicaid coverage to 133 percent of the “poverty rate”, which will disqualify them from Obamacare subsidies. Nine have already decided not to..

Some 100,000 Americans die each year from medical mistakes and infections acquired in the hospital. The Centers for Disease Control and Prevention estimate that one out of 20 U.S. hospital patients will acquire a new infection while hospitalized.

I say it’s time to retire the tattered old patchwork quilt and replace it with a new comforter. Maybe the VA system should be expanded from just soldiers to everybody. At the very least we should expand Medicare from the disabled and old — to all. Both systems have problems, but they are accountable to voters. Either option would provide cheaper and better healthcare, as other countries have demonstrated. Imagine the reduced paperwork. That would be good for both our physical and mental health both!

Michael Kaufman is a Bovina resident.