Health care reform: Much still to do

By Rob Stone, M.D.
Herald Times (Bloomington, Ind.), July 15, 2012

The Supreme surprise June 28 upholding the constitutionality of President Obama’s health reform still leaves much to be done before the American people will have a health care system worthy of a civilized nation. The Affordable Care Act (ACA) will never live up to its name as it contains insufficient cost controls to make care affordable. Hospitals will still charge $265 for a $2.25 tetanus shot. Insurance companies will continue to drive up premiums.

It was never designed to cover all the uninsured. The Congressional Budget Office had previously estimated that the bill would leave 26 million of the nation’s 50 million uninsured still uncovered, even when fully implemented. We await new projections, but preliminary data suggest that the Medicaid expansion ruled unconstitutional by the court will cut perhaps 8 million from the number who could otherwise expect to have been covered, leaving 34 million, or 11 percent of Americans uninsured. In the developed world, there is no other country with more than 3 percent of its population uncovered.

Too many of those insured under the ACA will have coverage so skimpy it has been described as “unaffordable underinsurance.” Millions will still be one job loss or illness away from bankruptcy.

Although the law is often referred to as “Obamacare,” it should better be called “Romneycare,” since the idea was originated by the Heritage Foundation, a conservative think tank, and famously passed by Gov. Romney in Massachusetts. Many have argued, myself included, that “Romneycare” doesn’t go far enough. Is it a step in the right direction?

What we really need is an improved Medicare for all — everybody in, nobody out. That solution is clearly constitutional. If we replaced our dysfunctional, profit-seeking, private insurance industry with a streamlined, single-payer system, we could save over $400 billion squandered annually on administrative overhead, enough to cover all of the uninsured and eliminate co-pays and deductibles for everyone else. Only a single-payer system can control costs and reduce our nation’s deficit over the long term.

In his weekly column in the Herald-Times, July 11, 2010, conservative commentator George Will wrote, “The new health care legislation is a step toward elimination, by slow strangulation, of private health insurance and establishment of government as the ‘single payer.’” May his prediction come true.

The American people need a universal health system that delivers comprehensive, equitable, compassionate and high-quality care, with free choice of provider and no financial barriers to access.

My dream is that Americans will one day join the citizens of other industrialized, capitalist democracies, from Canada to Germany, in being able to see a doctor without fear of personal debt or national deficit.

Dr. Rob Stone of Bloomington is director of Hoosiers for a Commonsense Health Plan.