Affordable Care Act: good news or bad?
By Samuel Metz, M.D.
The Oregonian, July 2, 2012
Is the Supreme Court decision upholding the Affordable Care Act good news or bad? It depends on who you are.
If you are President Obama, the news is good. The highest court in the land just validated the showpiece legislation of your first years in office. Election prospects just go brighter.
If you are Gov. John Kitzhaber or one of the 600,000 Oregonians in the Oregon Health Plan, the news is also good. This decision preserves critically important support from the ACA to the health care transformation process, a dramatic method of health care delivery with potential to provide better care at lower cost for 15 percent of Oregon's population.
And if you are a health insurance executive, the news is spectacular. The Supreme Court just confirmed a law requiring every American to purchase your product regardless of price, or face a penalty. Protests on the Supreme Court steps were drowned out by the clinking of whiskey glasses in health insurance boardrooms around the country.
For the rest of us, however, it is bad news indeed. Yes, the ACA will dramatically increase the number of insurance policies sold, but it won't make policies cheaper, nor will it make health care more affordable or more accessible.
In fact, the ACA will increase health care spending by $400 billion annually. This extra cost will not appear on the federal budget because costs are passed on to us, the patients, via compulsory purchases of insurance, increased premium prices and dramatically increased out-of-pocket spending.
Nor will the ACA protect American families from financial and medical catastrophe if one of us gets the wrong disease at the wrong time. Our most vulnerable families still face the unhappy choice of spending their last dollar on their mortgage or on their health care deductible.
Every industrialized country in the world provides better care to more people for less money than we do. None use our uniquely American style of private health insurance. Let's get real: If we plan a radical and painful makeover of our disastrous health care system, doesn't it make more sense to emulate these systems that work (using publicly funded universal health care) rather than one that doesn't? And the one system that we absolutely know doesn't work is the one we have now.
Unhappily, the ACA is guaranteed to produce one sure-fire result. Americans will become more dependent than ever before on private health insurance for their only access to health care. If you like what private health insurance has inflicted on our society up to now, just wait until you see what the newly approved ACA will do to us in the future.
Neither Congress nor the ACA will save us from health care Armageddon. We in Oregon must take charge of our future. It's time to create our own reality-based, cost-effective, publicly funded universal health care system and say tell the Supreme Court and ACA to take a hike.
Dr. Samuel Metz is a Portland anesthesiologist and a member of Physicians for a National Health Program and Mad As Hell Doctors, both advocates for single-payer health care, and of Health Care for All Oregon, an umbrella organization advocating for publicly funded universal care for all Oregonians.