I try not to get political in this blog, but current politics are directly involved in our healthcare and that is what I write about in this blog. I write this because all of my work is dedicated to improving the quality of life and for saving lives.
Candidate Mitt Romney has been very clear; he will work to repeal “Obamacare” on day one of his presidency. In a speaking engagement in Ohio Mr. Romney said that no one dies from the lack of health insurance. He also claimed that anyone with a preexisting medical condition can get health insurance.
Come on, who actually believes this?
It is pretty clear to me, if Mr. Romney gets elected, and you have a pre-existing condition, like advanced prostate cancer, you can forget getting health insurance of any type.
It is also clear that if you don’t have insurance, you increase your chance of dying prematurely.
Don’t believe me, then look at FactCheck.org – evidence that thousands of Americans die each year because they don’t have health insurance.
http://www.factcheck.org/2009/09/dying-from-lack-of-insurance/
Still don’t believe me, Harvard University has reported that 45,000 Americans die prematurely from lack of health insurance.
http://www.pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf
People die because they can’t afford to go to the doctor when they experience symptoms. When people who then go to the ER, their illness is far worse than it would have been had they sought earlier treatment. ER treatment is much more expensive then a trip to the doctor.
People die because they can’t afford their prescription medications, so they don’t fill prescriptions. When they do get their prescriptions they cut the dose back to make it last longer.
People die because they can’t afford preventive medicine or screening tests.
Again, I apologize to those who are upset about my political advocacy, but I am even more upset about the potential number of people who will die unnecessarily because they do not have health insurance. There is NO excuse for people to die because they have pre-existing medical conditions.
I struggle when I speak with a man with advanced prostate cancer who lives in another country and they cannot access the life extending drugs we have available in the United States. If Mr. Romney is elected and is able to repeal the healthcare legislation I will then have to explain to Americans why they too can not have these drugs that they will have to die prematurely.
This possibility makes me very unhappy and very angry.
Joel T Nowak, M.A., M.S.W.
Hey, Joel. Stress is not good for us guys with cancer. I think in the clear light of day on Wednesday, November 7, regardless of who’s elected (and at this point I am beyond caring), reality will suddenly set in on a variety of fronts and the nonsense we are hearing from the fever swamps of campaigning of both sides will finally cease.
Here’s my take on the healthcare issue. All of the pre-election huffing and puffing notwithstanding, I’m pretty confident the (somewhat ironically named) Affordable Care Act (ACA) will not be repealed. Why?
1. The Supreme Court ruling has caused most people to believe the ACA will be with us and has raised overall support for it. The reality of repealing the ACA will be a lot tougher than facile campaign promises.
2. If Romney wins, it will be by a hair; there will be no “mandate” and he will find himself hemmed in by a two-party political reality that he doesn’t have to worry about on the campaign trail.
3. Even if the Repubs were to take control of both houses of Congress (highly unlikely, IMO) the focus will first have to be on economic issues, not on health care. Like it or not, there’s a health care law already in place.
4. I think that the obstructionism of Tea Partiers will prove unpopular this November and while the Repubs will probably retain control of the House, many of those elected 2 years ago will lose. Those remaining will have been chastened by the loss of their former colleagues and perhaps will be willing to engage in more open bi-partisanship. Which I believe is what the public is seeking. We are pretty sick of polarization.
5. The fact that the House has tried to repeal the ACA 31 times has not captured the public imagination. It has only made them an obstructionist laughing-stock. This is not a strong base for ACA repeal.
6. Eliminating pre-existing conditions is the most popular part of the ACA, so whatever would theoretically replace the ACA would have to include the same basic pre-existing language of the ACA because insurance companies won’t be any more popular then than they are now.
Having said that, I think it is much more likely that we will see a series of unintended consequences of the ACA that will have to be fixed incrementally by legislation to revise its more misguided parts. It will be a very messy process, but
In the end I think we are much more likely to see a revised ACA than a repealed ACA, even if Romney wins the presidency.
Some of the consequences of the ACA we are likely to see include, IMO:
1. Loss of jobs from the US due to the 3.8% medical device tax taken from revenues (not profits). (My brother-in-law who works for J&J says this is already happening.) Repeal of this tax will place significant financial stress on ACA funding sources.
2. The fact that there are not enough docs to deal with a huge new influx of the newly insured. Have you tried as a new patient to get a PCP or specialist in Massachusetts? I have, and it’s virtually impossible, especially outside of Boston.
3. Some form of relief from paperwork for hospitals and docs as it becomes apparent that the ACA is creating a vast and inefficient bureaucracy and the promise of electronic medical records will turn out to cost more rather than save money. (I could explain why, but this post is already too long.)
4. The emergence of “boutique” or “concierge” medical practices for the wealthy, further widening the divide between rich and poor.
5. Dealing with the fact that employers will be much more likely to be willing to pay the $2,000 to $3,000 per employee penalty for not providing healthcare coverage, casting their employees into the ACA-funded insurance exchanges, causing even greater pressure on the already enormous cost of the ACA.
6. Dealing with the Independent Payment Advisory Board (IPAB) which is going to be under severe pressure to limit cost (See above and See N.I.C.E. in the UK). That, IMO, is where we are likely to see the restriction or even outright loss of coverage of expensive advanced cancer drugs, not because we had a pre-existing condition.
Sorry to go on at length. I am generally in favor of the ACA because it is a start, albeit a badly designed one. But to repeal it and replace it with another ill-designed law is hardly a rational solution. As an engineer I can say only that there is no free lunch; everything has a cost. As noble as the ACA cause may be, it will exact cost in every sense of the word and create a variety of unpleasant, unexpected surprises. We should be prepared.