On myriad levels, Obamacare is a good plan, and ultimately I am in favor of seeing it fully implemented. But if we eliminate emotion and politics, it’s fair to say Obamacare is only half of what is required.

Affordable? Maybe not. Necessary? Likely so.
Part 6 (of 8) of the Off The Reservation special election series in the Long Island Press

It has been said that death and taxes are the two irrefutable realities of our existence. By declaring the act that seeks to prolong death for every American to be a tax, the U.S. Supreme Court has neatly fused them together, making the debate surrounding Obamacare an inescapable reality unto itself.

My election series of columns has thus far made clear arguments in favor of re-electing Barack Obama with respect to the stimulus, deregulation, foreign policy and appointing justices to the Court, with Obama winning three of the four topics convincingly and a split decision on Wall Street regulation. When it comes to healthcare, I must admit that I am struggling a bit. Perhaps you can help.

Intellectually, I am a fan of a single-payer healthcare system. In America, this would essentially mean Medicare for all, with no option for private health insurance. The administrative cost and paperwork associated with patient care would be a fraction of what they are today and with the advent of electronic medical records an argument can be made that there are significant efficiencies to come. Practically, however, this is essentially the Canadian system and it is far from perfect.

My family is originally from Canada and most of my relatives still live there. While there is no question that general care is indeed more affordable, available and efficient, critical care is a problem. My aunt died prematurely due to the ridiculous lengths she had to go through to receive a proper and thorough diagnosis. But this painful anecdote belies statistics that suggest the mortality rate from disease in the US and Canada is nearly identical.

Doctors in the United States are compensated much higher than doctors in Canada; but this applies mostly to specialists and not general practitioners. Therefore, in Canada there are far more general practitioners per capita than in the United States. Perhaps this implies that although critical care is less available, greater access to preventive care mitigates the severity and incidence of diseases that require critical care. Frankly, I don’t know. But I do know, just looking at Long Island for example, that we have universal healthcare because the emergency room at Nassau University Medical Center is just about the busiest place on the Island. This is why I am in favor of an attempt to cover every individual in the United States and, for the most part, a proponent of the Affordable Care Act, or “Obamacare.”

When I began working for my father 18 years ago, we covered 100 percent of healthcare costs for our employees. Now, we can only afford to cover half. Moreover, this “half” is far more expensive than the entire amount was almost two decades ago even on an adjusted basis. It’s why I find it insulting when people suggest that Obamacare is crushing small businesses already. The fact is, Obamacare hasn’t been fully implemented yet, but this is the first year that two very significant things happened to our business:

  1. We were reimbursed several thousand dollars by our insurance company because they had failed to meet the minimum standards under Obamacare for the amount of money that must be allocated to actual care, and not administrative costs.
  2. This is the first year the insurance company didn’t attempt to raise our premiums by double-digits.

So, as a small business owner, I have already benefitted from a plan that hasn’t even been fully implemented. Moreover, it puts my business on a level playing field with other small businesses I know that skirt the rules by paying their people as independent contractors simply to avoid offering them health insurance.

There are other great parts of this legislation such as extending dependent care, outlawing the practice of declining coverage for anyone with a pre-existing condition, closing the Medicare “donut” hole for seniors, mandating electronic records, and identifying best practices across the nation. But I have heard time and again that Obamacare will ultimately result in a massive decrease in reimbursements for physicians— forcing them to see more patients to sustain current income levels—thus jeopardizing the quality of care.

This is a practical sentiment that I can sympathize with, but many of my friends who are physicians have been complaining about this for years. This isn’t an “Obamacare” phenomenon; this is a “healthcare-as-it-currently-is” phenomenon. And while I agree that adding millions of additional people to the insurance pool is beneficial for insurance companies and detrimental to the earning potential of physicians, access to preventive care and wellness visits is undoubtedly a positive step for America. I’m hoping my physician friends weigh in on this to express their viewpoints because I know many of them are tired of being businesspeople and accountants and simply want to get back to caring for patients and growing as doctors.

The politics surrounding Obamacare have drowned out any and all reasonable debate surrounding this issue. The mere fact that the GOP vehemently opposes this plan that was originally crafted by a conservative think tank, touted by Republican legislators and actually adopted fully by a Republican governor now running for president should indicate how toxic our politics are. On myriad levels, Obamacare is a good plan, and ultimately I am in favor of seeing it fully implemented. But if we eliminate emotion and politics, it’s fair to say Obamacare is only half of what is required. The real drivers of cost in the system are the high-cost liability insurance, rampant pharmaceutical dependence encouraged by advertising that is unnecessary and unethical, an overly-litigious culture that forces physicians to order unnecessary tests simply to thwart potential claims, paying doctors and hospitals per procedure instead of paying for the care the patient requires, and the extraordinary cost of end-of-life care. If over the next decade, Obamacare is married with serious attempts to tackle these issues, then it has a shot at not just succeeding but being a model system. If not, it will likely lumber along as a quasi-failure but no worse than had we done nothing at all.

WEEK 6 goes once again to the POTUS.

PHOTO: Barack Obama signs the Affordable Care Act into law, March 23rd, 2010. The act is the most sweeping healthcare reform since Medicare and based largely on initiatives created by conservative think tanks. (AP Photo/Charles Dharapak)

Author: Jed Morey

Jed Morey is the publisher of the Long Island Press, LI's Cultural Arts and Investigative News Journal. The Press has a monthly circulation of 100,000, and www.longislandpress.com, welcomes more than 500,000 unique visitors every month. He serves on the board of the Holocaust Memorial and Tolerance Center in Nassau County, as well as the President's Council of Big Brothers and Big Sisters of Long Island. In addition to the contributions on this blog, Morey authors a column for the Long Island Press titled "Off The Reservation" and is a staunch advocate for Indian rights. The column was voted Best Column in New York by the NY Press Association in 2010 and third overall in the nation among alternative publications by the Association of Alternative Weeklies in 2012. Morey lives in Glen Cove with his wife, Eden White, and their two daughters.

6 thoughts on “Obamacare”

  1. I completely agree that single payer, Medicare for all, is the way to go. Did Obama cave too soon to win the votes of Republicans who were never going to vote yes anyway? Maybe. Was single payer never even on the table? Also maybe.
    In ACA we have the start of healthcare for all Americans and that’s sure better than what we had before. My hope is that ACA will evolve to serve more people, more efficiently than our current hopeless, extremely expensive delivery of healthcare is in this country.

  2. Yes sir, spot on! Single payer absolutely IS the answer. While the system in Canada may not be perfect, there are also other single payer systems around the world that have enjoyed a good amount of success. Israel and Germany come to mind first, based on what I heard a few months ago during Romney’s ill fated visit there.
    Three things that will, someday make a single payer system successful:
    1. tort reform, which your article identified expertly
    2. elimination of for profit insurance companies from the picture
    3. elimination of the employer based situation that currently exists
    We are, to the best of my knowledge, the only country in the world where health care is tied to employment. That, in and of itself, creates myriads of problems, as you well know and described in your article.
    Thank you so much for your expertise!

  3. In pharmacy, the government sold it`s soul to insurance companies 5 years ago when they gave them the green light to run the drug coverage portion(Medicare D) of medicare. State Medicaid programs, including NY, followed suit soon after. In 2013 NY state will have 13 Medicare D plans competing for eligible enrollees. Why are they competing? The government conceded that they could do the job cheaper than they could. They also convinced them that beneficiaries healthcare and access would not be compromised. They basically said we are too stoopid to fix it ourselves. I am making up numbers!!! In NY state the drug portion of Medicaid for 2006 is 100 million dollars. The insurance companies come to the table and say to Medicaid, ” For 50 million dollars we will provide the exact same drug service to all your beneficiaries.” State subsidizes insurance company 50 million. Remember that they are not providing service for half price, because they did not even take there profit yet.
    Two questions. How inefficient has the government been running this program? How many corners and backdoor moves(screwing beneficiaries) do the insurance companies need to make. It`s like a stripper telling you lap dances are 20 dollars, but for you, she will only charge 5. Odds are she has a penis. More to follow.

  4. October 19, 2012

    Dear Jed,

    I just read your ‘Off the reservation’ series Part IV: Obamacare.

    I think you got everything right, until you mentioned the “…overly-litigious culture…”. My thought on the matter is something that I have not heard mentioned. Once we have Universal Health Care, meaning that every one has unlimited coverage for medical conditions, there will be a dis-incentive to sue. The injured party will no longer have to pay for medical care.

    Subtract the actual, and/or the potential medical costs caused by medical malpractice, and awards will go down significantly. I don’t know what percentage is attributable to medical costs, but I imagine it is large part.

    If the potential award, not including medical expenses, is lower, wouldn’t that cause attorneys to rethink the taking, and filing these cases? The payments seem to be based on the total award.

    Another problem, and this affects all people, is when settlements are made, without admitting negligence, and a secrecy agreement is attached, then negligent doctors are let off, insurance rates rise, and we all suffer because we don’t know the guilty doctors. I have heard of some doctors with a few of the agreements, but I, as a layman, am not privy to these statistics.

    Sincerely yours,

  5. Ahoy there, Jed!

    Thanks for writing this informative article. And thanks to each of the people who also took the time to write a reply.

    I’ll be the first to admit that I know very little about our nation’s healthcare system. I know that my employer makes sure that I have strong medical coverage (with Oxford / United Healthcare), strong dental coverage (with MetLife), and strong optical coverage (with Avesis).

    In 1974, I sustained a head injury while living in Vermont. The impact robbed me of half my hearing, in both ears equally. I was three years old. My parents (on welfare and food stamps) somehow managed to afford hearing aids for me.

    My hearing loss steadily worsened until 1990, and today it’s approximately a 90 percent loss of hearing in both ears equally. I purchase new hearing aids once every five years or so. My current hearing aids costed me $6000.00; all of which was out-of-pocket, with zero help from my healthcare provider.

    I’m sure that the current healthcare system in this country makes a whole lot of sense to someone, but that someone sure isn’t me.

    As a handicapped person, who relies on hearing aids for quality of life, who must pay out-of-pocket for hearing aids, I’ve been shown that the government has no answers for someone like me. As such, I turned my back on my government, and I don’t mind saying so.

    I’d love to be able to feel like the government has my back. Perhaps someday I will feel that way. Until then, I hope that you’ll excuse me for not being all that interested in politics.

    Your journalism is still noteworthy, even if our nation’s healthcare system is not, and you can continue counting on me to be amongst the readership.

  6. Tim. I wonder if coverage will improve to the point where this will be covered in the future. Hope so, because you belt out tunes like a soulful motherfucker. Would be a shame for us all if you lost that gift and ability.
    Thanks for sharing your story and being a devoted reader of the LI Press.

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