ALPERN AT LARGE-It's truly fascinating how the Affordable Care Act is rapidly approaching, yet the spin from both Washington, DC and the press appears to be more about making political points than about improving health care while making it more affordable.
And the medical establishment (including your doctor and/or other healthcare providers) is as confused as anyone as to whether this whole process is good, bad...or maybe a bit of both. So here's we stand, folks--and as a physician, I really do want what's best for my patients and for the rest of humanity (particular this nation):
1) Health spending is going to go UP, with spending going up in our nation from 18-20% of the U.S. Economy. This might be good in the short run, because many of us aren't putting into the system, and there are unmet health needs that are hurting individuals, families, and our economy...but "healthcare reform" isn't at this time addressing the impacts healthcare spending is having on the country as a whole.
2) It's nice that conservative Republicans have their own plan for healthcare reform, but much of it emphasizes what individuals can do for themselves, and not on what the country can do for individuals...which is the classic paradigm debate between Republicans and Democrats over the role of government. And while too many Republicans have ignored the economic impact of health care costs for too long, Democratic-leaning unions are discovering that they, too, will suffer increased costs while seeing others benefit from the health plan premiums they will pay thousands more year. A pox on both the GOP and Democratic hardliners, because they're both bringing us down!
3) Young folks and minorities who flocked to the polls in 2012 to reelect Barack Obama might wonder if they--arguably the President's primary constituents in last year's election--have truly come through for them. Jobs are still unavailable for youths, particularly minority youths, and full-time jobs with benefits are even less available than ever. Part-time jobs without benefits might or might not be available, but unemployment and underemployment are as horrific and life-destroying in this nation as ever...and the question of whether ObamaCare is exacerbating this problem is as timely a question as any.
4) The aforementioned underemployed and unemployed are NOT going to see Mitt Romney, Donald Trump and Warren Buffett pay for their health insurance...many of them will be effectively grabbed by the scruff of the neck to the health care exchanges and be required to pay into the system and get their own insurance.
5) The fine to not get insurance is not that painful yet, but in future years the need of everyone to GET INSURANCE will be less and less possible to avoid...and it should be remembered that the Supreme Court okayed the Affordable Care Act NOT because it insurance was constitutional, but raising taxes is. Folks, this is a tax hike, regardless of whether we believe it was necessary or not.
6) Companies are trying to either keep their greedy megaprofits up, or trying to survive in an economically challenging time--depending on your point of view--so as they move employees to part-time status in record numbers, and/or refuse to hire at all, it might be a good idea to ask ourselves what the role of employers are in our 21st century global economy, where they can and do move manufacturing jobs wherever they want. Perhaps it's time to ask those demanding higher corporate taxes to STAND DOWN and demand employers only cover retirement and health benefits to keep our nation an attractive and competitive place for employers to hire (even if you despite them).
7) Expanding Medicaid (Medi-Cal in our state) has always been an attractive idea to both Republican and Democratic governors and other legislators, because it never makes sense to have people choose to NOT work in order to keep their health care benefits...so clearly the portion of ObamaCare that expanded Medicaid is one that is quite different than other portions that are less tenable to employers (who've been given a year's delay to be part of the new system because of their unhappiness with the Affordable Care Act). It should be remembered that GOP Governor Pete Wilson helped start the California Healthy Families program which expanded Medi-Cal to more working poor, and that this idea is NOT new.
To close, we're now learning more and more about the Affordable Care Act, and its ramifications and consequences, and unlike Nancy Pelosi's predictions, many of us aren't too thrilled about it, and are liking it increasingly less with the passing of each new day. There certainly ARE positive features about it...but as with all policies it might have been a good idea to have both parties on board to craft a proper compromise, and with the input of both loopy liberals, creepy conservatives, and everyone in between.
But one thing we can all agree upon: if ObamaCare (the Affordable Care Act) is such a great idea, then perhaps the President, Congress, and all federal employees, connected unions and employers can and should ALL be part of it as a shining example of the right thing to do in our wonderful United States of America.
(Ken Alpern is a Westside Village Zone Director and Boardmember of the Mar Vista Community Council (MVCC), previously co-chaired its Planning and Outreach Committees, and currently is Co-Chair of its MVCC Transportation/Infrastructure Committee. He is co-chair of the CD11 Transportation Advisory Committee and chairs the nonprofit Transit Coalition, and can be reached at [email protected]. He also co-chairs the grassroots Friends of the Green Line at www.fogl.us. The views expressed in this article are solely those of Mr. Alpern.)
-cw
CityWatch
Vol 11 Issue 76
Pub: Sept 20, 2013
