Medical practice and healthcare policy are on a collision course.
From an intellectual perspective, we are entering a golden age of the healing arts. The full promise of genomic medicine informing diagnosis and treatment beckons from just over the horizon. Younger physicians, just entering practice, have the ability to alleviate human suffering that no generation of doctors has ever previously known.
But not so fast.
The administration of health care policy, and ultimately dollars, are also undergoing a generational shift. But this shift is founded on some of the most irrational politics this country has ever seen. Future generations observing the political changes of the past five years will invariably say, “what were they thinking?”
The Affordable Care Act was not the product of any informed or learned group, it was a hastily contrived political farce that was literally cobbled together at the last possible minute. It was never intended to become law — except that it did. For the past 3 1/2 years literally “all the kings horses, and all of the kings men” have pushed and prodded to give it the appearance of workability. We are on the threshold of finding out if they were successful.
In medicine, we sometimes talk about the compression of morbidities, how the ravages of time and multiple maladies may overwhelm the patient at the end of life. That compression sequence also seems to describe afflictions of the Affordable Care Act as it careens towards implementation.
What a missed opportunity. For decades, the cost of healthcare and health insurance has worried Americans. And as we get closer to the full implementation of the Affordable Care Act, costs are not shrinking, they are only going up — way up.
Where was the innovation when this scheme was contrived? Why not look at some of the state models, such as the Healthy Indiana program, which reduced costs over 10% in a two year span? Where was the study of vertically integrated delivery systems such as the Mayo and Cleveland clinics?
Last week a headline in the Wall Street Journal reported that Walgreens has told their employees that they were not going to pay for health insurance coverage any longer, we will give you money instead, good luck in the exchanges and we will see you on the other side. Walgreens is only one of many companies such as UPS, IBM, and Trader Joe’s that have announced that they are dropping family coverage. Several Unions wrote to the minority leader in the House of Representatives and the majority leader in the Senate stating: please help us. We helped you manage your phone banks and walked neighborhoods for you. We helped you get elected. The administration is not listening to us. They have broken the contract with working Americans by voiding the 40 hour work. By redefining full-time employment as 30 hours, they have essentially broken the back of the middle-class.
The American people, regardless of political persuasion, are crying out for help.
It’s hard to overlook the big pieces of the president’s health care plan which are simply being ignored or jettisoned. From coverage of pre-existing conditions, to annual caps on out-of-pocket expenditures to the suspension of the employer requirement to provide health insurance; the administration has signaled that in many ways it is not serious about the implementation of this law.
And yet in hearing after hearing, directors of federal agencies maintain the assertion that all will be ready for people on October 1 to sign up, and January 1 to receive benefits. And not to worry, order will surely emerge from this chaos. Unless it does not.
This all leads us to the most important question. What kind of country and ideals we want to leave to future generations?
America was supposed to be a place where people could pursue their dreams in peace and without interference. The government was supposed to provide them with protection without disrupting their daily lives.
We were supposed to be different than the governments of Europe which dominated every aspect of their citizens’ lives. Obamacare represents a giant leap toward European-style socialism. If we can agree as a nation that that is what we truly want, let’s stop pretending to be a nation that holds the freedoms of its citizens’ in the highest regard. If on the other hand, we are truly a nation for, of and by the people, the people cannot be passive and expect freedom to last.
Congressman Michael Burgess represents the 26th District of Texas. He serves on the Rules Committee and Energy and Commerce Committee.
Dr. Ben Carson is an emeritus professor of neurosurgery, oncology, plastic surgery, and pediatrics at the Johns Hopkins School of Medicine.