Another look at health care reform

Since health care has been such a critical issue in the Arkansas senatorial election, it seems appropriate to offer some facts and analysis. Let me state up front this is my professional analysis and not the official stance of UAFS.

A brief discussion of the Patient Protection and Affordable Care Act (ACC) – the full text which can be found here – is in order.

Often derisively and erroneously referred to by conservatives as “Obamacare,” it is strange that one thing they find objectionable with ACC is the requirement that individuals carry health insurance. The irony is that it was originally their idea (http://www.forbes.com/sites/theapothecary/2012/02/07/the-tortuous-conservative-history-of-the-individual-mandate/).

One of the things that the ACC tried to address was the “free rider” problem. This is where someone does not buy insurance for whatever reason, gets sick or injured, and goes to the emergency room for care. Often they can’t pay their bills, so the hospital passes on the cost to, you guessed it, the rest of us in the form of inflated bills and premiums.

A proposed solution to this problem came from the conservative Heritage Foundation. In “Assuring Affordable Health Care for All Americans” Dr. Stuart Butler advocated, among other things, a national mandate requiring all Americans to carry health insurance.

This would eliminate the free rider problem and lower health care costs. This would also fulfill an implicit contract between the sick and society. Recognizing that health insurance is not like car insurance, where society is under no moral obligation to fix the uninsured’s’ car, Butler states, “If a man is struck down by a heart attack in the street, Americans will care for him whether or not he is insured or not … we may be angry but we will not deny him services – even if that means more prudent citizens end up paying the tab.”

The ACC we have was modeled on a Massachusetts law that was signed by then Gov. Mitt Romney. It was based on a Butler’s idea and tacitly supported by a Republican governor and presidential nominee. So it is ironic that conservatives would fight with such acidic vehemence the current Act. One has to ask why. Could it be that they are mad because their idea was put into place by Democrats in Congress and signed into law by a Democratic president? Or is it because our President won two elections in part because of his support for reform?

What is clear is that reform was and is necessary. Millions of uninsured, health costs nearly twice that of other developed nations, with questionable results, pointed to a need for change.

In 2007 The American Journal of Medicine performed a national survey and found that 62% of household bankruptcies for that year were due to medical debts.

Change was necessary. In a future post I will discuss the reform that should have taken place.