Doctor's In: Obamacare or Nobamacare? That is the Question

I will preface my comments by saying many doctors disagree with me.  That’s fine and appropriate for such diversity of views makes America great.  Forgetting Obamacare for the moment, properly called the “Patient Protection and Affordable Care Act.”  Let me ask the big question. What should an ideal US health plan accomplish?  I suggest the following:

• Every U.S. resident should have equitable access
  to health care
• Health care costs should be affordable for all
• Administrative costs and profits should be regulated
• Pharmacy should be included
• Providers should be adequately compensated
• Patients should be able to choose their health
  care provider
• No one should face financial ruin due to health
  issues
• Health care costs should be contained
• Dental health, optometry, podiatry and mental
  health should also be covered
• Long-term care should be incorporated into the
  plan

Question: Can this be accomplished? Answer: It must be accomplished for a healthy and productive citizenry.

Question: Has Obamacare met these criteria?  Answer: No.

Wherever you stand on Obamacare, one must understand the
importance of universal health care coverage. Populations without coverage or equitable access represent serious infectious health risks and financial burdens to all of us. Many cannot work due to untreated medical conditions.

We pay a very high price for the uninsured to get their care. It affects our own health care bills, access to health care and our health insurance premiums. It also forces employers to push the burden of health care costs onto their employees.

I volunteer in a free clinic and many of my patients need a lot more than I can provide. We simply do not have the resources for the specialty care or possible hospitalizations that they might need. Often we must tell them to find a cardiologist or surgeon as we have no referral source.  

Sometimes it is necessary to tell a clinic patient to go to the Emergency Room for the most expensive kind of care. Often, prescriptions are unaffordable. One of four Floridians are uninsured; about one in five nationally. As seniors have Medicare, the uninsured populations are all under 65years of age.

Obamacare’s greatest deficiencies relate to still leaving millions uninsured, not adequately addressing administrative fees or insurance premiums, and not providing a more efficient option to private insurance. These failings may well have doomed the plan or without tweaking delay many of the desired benefits of universal access. I see Obamacare as a first step to resolving the major crisis of America's health care.

A one-payer system has strong support. Opponents are concerned that a one-payer system would be socialized medicine. That is not the case. Medicare is an example of a one-payer system and it protects the private provision of health care. It could not be defined as socialized medicine. It does keep administrative costs down and address the profiteering so much a part of the private health insurance industry.

I continue to advocate for a one-payer system. Medicare for all is an excellent design. Will it give us our ideal health care system as described above? No, but it will bring us much closer and make all the elements more affordable.

Comments and suggestions are always appreciated.