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December 5, 2013
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My Turn: Health care — no on status quo

I applaud Mary Thompson and others who are standing up to conservative bashing of the ACA (Affordable Care Act or Obamacare), most recently by Representative McClintock and now state senator Ted Gaines.

I fail to see why they are so proud of a health care system that by most measures falls about 40th in the world, 30th in life expectancy just behind Slovenia.

I prefer to point to corporate greed (read insurance, medical device manufacturers and big pharmacy) and complicit and tainted elected officials and lobbyists.

Yes, Mr. McClintock, we have the best health care money can buy — the problem is only the rich can afford it. Mr. Gaines, voting against a minimum wage bill, seems to think 8 dollars hourly should support at least “disaster” insurance (which it doesn’t). Disaster insurance is also their option for the young.

Disaster insurance (covers little and high deductible) is aptly named. The subscriber is usually responsible for the first 3-5 thousand dollars, which discourages any contact with health care until you are so sick you need the most expensive care via the ER or hospital.

That cost is a disaster to most living on the edge (seemingly the majority), as the initial deductible and the percentage after that have left many bankrupt. ACA wisely forces insurances to cover vital services — given shootings, bombings and suicides, can anyone question the need for more mental health coverage?

ACA also requires insurances to actually spend money on health care and not on investors and CEOs.

The other countries ahead of us seem to understand, as we do begrudgingly, that health care is a right (remember we have a law that no hospital or ER can refuse care). They pay for it up front, while encouraging primary and preventative care.

Copious data show money saved, not more cost, as our Republican friends claim. Oh by the way, it makes the population healthier. We pay at the back end with your taxes for uncompensated care and trying to squeeze the life out of hospitals and providers.

This has led to hospital closures and lack of access for many on Medicaid (MediCal) and Medicare. Frankly, the reimbursement on both are insufficient to stay in business. Take note, Mr. Gaines, California is nearly the worst in Medicaid reimbursement and refuses to follow mandates from the ACA that requires at least Medicare rates for doctors who are still willing to take MediCal.

Your voting record suggests you are more interested in keeping assault weapons handy.

In our culture of impatience, recall we elected Obama, with the ACA a signature issue. Undeniably, the rollout was a disaster, but our representatives are in the vocal minority. Current polls show only about 45 percent of citizens support the ACA, but the opposition include the 15 percent who want single-payer, the more “radical” move.

In truth, one can make a pretty good case for a basic single payer (see the top 40 systems, virtually all spending way less on health care than we do). America is not nearly ready for anything that simple, thus the ACA.

As for a move toward socialism, nonsense. We provide the service anyway, much as all have roads and police. It is a matter of doing it more wisely.

Are health providers excited about these changes? In general, no. Painful, yes. For many like me on the front line of primary care, we wish to see all our patients and make a fair living.

No question, difficult changes and confusion exist on both sides of the patient/provider relationship. That said, models exist where ACOs (Affordable Care Organizations) can save enough to make it work for both.

What is needed is to get the naysayers out of the way long enough to give it a chance and modify as needed. Instead, we get politicians who want to stop all government by intransigence or filibuster rather than making the best of a new idea.

Have we all lost faith in health care changes? It appears not. With some website cyber-surgery, about 10,000 people are applying daily. I urge our representatives, who seem proud of blocking everything Obama offers, to compromise and move forward on a law already on the books.

Meanwhile, take up issues, especially in California, that keep health care underfunded and the whipping boy for the budgetary imbalance. Consider Oregon’s experiment with limiting conditions and providers to the vital, then allow the free acquisition of supplemental care.

Flush out the initial bath water, but give the baby a chance.

Christopher Arth, MD, is a Truckee pediatrician who has been practicing medicine in the Truckee/Tahoe area the past 33 years.

As for a move toward socialism, nonsense. We provide the service anyway, much as all have roads and police. It is a matter of doing it more wisely.


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Tahoe Daily Tribune Updated Dec 5, 2013 03:23PM Published Dec 5, 2013 11:56AM Copyright 2013 Tahoe Daily Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.