Ball of confusion

Description fits both the Affordable Care Act and most of the GOP opposition to it

By Jack Bernard
Ledger-Enquirer (Columbus, Ga.), June 8, 2013

In my rural county, the Tea Party was started by, and is still headed by, a Republican blue-collar trade union worker from New Jersey who looks and sounds like someone you would see on "The Sopranos."

He has not worked for years, is under 65, and gets health insurance through his trade union. He constantly and loudly complains about Obamacare, which when implemented will help older unemployed people like him (but not in a trade union) to get coverage. Influenced by extremist propaganda, I doubt he realizes that uninsured older workers currently either: (a) cannot get insurance at all, or (b) cannot afford the excessive age-adjusted and health-adjusted premiums charged by for-profit insurance companies.

Remember the contradictory signs carried in 2009 by Tea Party senior citizens saying "Stop Obamacare; keep the government out of my Medicare"? In 2010, Dr. Paul Broun, my own Tea Party-endorsed congressman (now running to succeed Senator Saxby Chambliss), declared that under Obamacare, "the elderly are gonna be denied the care to keep them living." His weak rationale was that he bought the misleading and factually incorrect Sarah Palin "death panel" ruse.

Unfortunately, these are the confused folks at all levels who are still heavily influencing my party, the GOP, and its policy positions on health reform. Thus, we see the recent highly partisan 37th vote for repeal of Omamacare by our out-of-touch House of Representatives.

Am I a dyed-in-the-wool supporter of Obamacare? No, I am not. There is a much better alternative that I outline below. (The main thing I support about Obamacare is that at least it will help in providing coverage to some of the 50 million Americans who are currently without insurance.) But that does not mean that I endorse the misguided direction that my own party has taken on health care.

The GOP currently has two big new ideas regarding health reform, both doing away with so called "entitlements" that are very popular with taxpayers. Neither initiative makes any sense in the broader context of systemic cost reduction and quality improvement.

First, the GOP wants to change Medicare into a voucher program. Let's be clear as to the underlying aim of this "premium support" proposal: A voucher system would cap expenditures by the federal government, period. It does nothing to make the health care system more effective, quality-wise or cost efficiency-wise. By providing vouchers, you just shift the burden of ever-increasing hospital, physician and pharma costs onto powerless, sick patients. Over time, this means that the elderly will not get the care they need … or they will go broke trying to pay for it. Is this an appropriate GOP national goal?

Second, the Republican Party proposes making Medicaid, the safety net for the poor for the last 50 years, into a block grant program. Again, costs to the federal and state government are capped. But that simply means that Medicaid beneficiaries, all very low-income people, will suffer tremendously and fail to receive needed care. Plus, most Americans are unaware that the largest payer for nursing homes is Medicaid. Do you really want a sick, frail, elderly person who has worked all his or her life to be out on the streets just because there is no government funding to put them into a nursing home?

The best solution is starring us in the face: Expand Medicare and make it the sole payer for all health care. It is one the few areas where government has proven to be more efficient than the private sector. Medicare administrative costs are 3% versus 20%-30% for private insurance companies, which have lots of administrative and marketing overhead.

When we look at European countries and Canada with similar systems, we find that statistically their quality of care is as good as or better than ours, and costs are much less. For example, the per capita cost of care in Canada is $4,205 versus $7,910 in the United States. France, with possibly the best health system in the world, costs only $3,835 per capita.

More on this topic can be found on the web site of Physicians for a National Health Program, PNHP. Go to for more regarding how a Medicare For All system would work and the clear benefits it would bring to all Americans.

Jack Bernard, a retired senior executive for several national health care corporations, is also the former Director of Health Planning for the state of Georgia and former chairman of the Jasper County Republican Party;