A perfect storm of healthcare crisis has descended on us. Right in the midst of the Great
Recession the baby boomers have begun to retire at the same time as the obesity epidemic blooms, portending an explosion of heart disease and diabetes. In a perfect world this should cause all Americans to candidly re-examine the proper role of the government in healthcare and our own collective responsibility for the general welfare. Instead there seems to be mainly anger at incumbent politicians for not providing what we all want for free.
Healthcare again? Sorry, I know you don’t want to hear it, but it’s the 900 pound gorilla in the room and it isn’t going away. In fact, it’s getting mad as hell.
The media seem to be in agreement that the GOP is on the eve of sweeping election gains that will leave them in control of both houses of Congress and as we all know one of the first mandates of their Pledge to America is to rescind Obamacare. This will present them an opportunity to be more than the party of “NO.” Make that “obligation”, not “opportunity.”
Also, there are court challenges being brought against the program by 20 states for unconstitutionally forcing the 40% of potential but uninsured healthcare customers to pay into the system. Given the right-slanted Supreme Court right now one has to think it would be receptive to junking it.
As I have posted before, Obamacare is not really insurance but a government mandate that all citizens share the cost of healthcare, including that for pre-existing conditions and major illnesses. Although some call it socialism, IMHO President Obama deserves credit
for even daring to tackle this historically-intractable problem. Obamacare would at least slowed the rush to the financial cliff. If repeal happens, or if one of the state lawsuits is successful, won’t the GOP then have to propose to replace it with something? Given the rhetoric of the campaign, the president could hardly be blamed for accepting such a GOP plan as a mandate from the voters .
At the center of the financial problem is a law that has been in effect since 1986: the Emergency Medical Treatment and Active Labor Act (EMTALA). It requires hospitals and ambulance services to provide care to everyone, regardless of ability to pay. According to the Centers for Medicare & Medicaid Services, 55% of U.S. emergency care now goes uncompensated. When medical bills go unpaid, health care providers must either shift the costs onto those who can pay or go uncompensated. As a result hospitals have raised prices to absurd levels to try to recover as much as they can. Many ER’s are shutting down and hospitals are struggling financially. The situation is unsustainable.
Congress won’t have long to act because things are getting worse quickly. Financial pressures on hospitals in the 20 years since EMTALA’s passage have caused them to consolidate and close facilities, contributing to emergency room overcrowding. According to the Institute of Medicine, between 1993 and 2003, emergency room visits in the U.S. grew by 26 percent, while in the same period, the number of emergency departments declined by 425. Ambulances are frequently diverted from overcrowded emergency departments to other hospitals that may be farther away. In 2003, ambulances were diverted over a half a million times.
Republicans have offered a variety of “solutions” to the problem, but none seem to me to come close to providing what is needed, which is, to use Anson Burlingame‘s recently-uttered phrase, to “make available” good healthcare for all Americans. Easier said than done of course.
What is missing of course is cost-feedback to the consumer. Neither Obamacare nor any GOP plan I’ve seen comes close to solving the ballooning costs of medical care. Interestingly, doctors have some ideas on how to cut healthcare costs, but none of them seems to know how to implement them. Clearly, at least to me, government needs to step in and take ownership of the problem. So here is my challenge to the GOP. Congratulations in advance on your impending win in Congress. Now, what are you going to do to bring down healthcare costs, and what will you replace Obamacare with? Please hurry – we’ve been in the national ER way too long out here. The emergency has arrived.