HEALTHCARE POLITICS-When it comes to vital things like healthcare, or transportation, or utilities, the battle of whether to have government play a huge role, or just an oversight role, is one that must be fought. All sorts of internal and public debates have to be pursued, and tough issues confronted, because people will otherwise get hurt.
Whether it's to libertarian purists (who might mean well but aren't always realistic) or big government purists (who might mean well but also might be creepy and clever tyrants at heart), the issues of what's Constitutional versus what's Big Brother, and what's free choice versus what's pragmatic, are difficult yet can't be ignored.
And while the Affordable Care Act (ACA) is the law of the land, more and more Americans are concerned about the fiscal and quality-of-care consequences of this well-intentioned but ham-handed effort to reform American health care.
At this time, more Americans believe the ACA hurt then helped healthcare, not the very least in that they question how "affordable" it truly is.
As a physician, I've seen a few patients' lives and health helped by this law (certainly a good thing!), but most of my cash patients found this too expensive, and Covered California patients aren't just limited from my own clinics but to the majority of local and regional medical clinics.
To say nothing of the painful fact that the full costs have yet to be borne by American employers and taxpayers. There's a reason why the President has placed so much of this on hold.
So along comes Proposition 45, which perhaps was what the ACA was supposed to do ... it's the costs, stupid!
Unfortunately, Proposition 45 places too much power in one person's hands (the California Insurance Commissioner) to approve health plans' insurance costs...or to not approve them.
Do Proposition 45's supporters and backers mean well?
Arguably, yes. But will it work?
--Will it prevent doctors and medical groups from being excluded by health plans trying to save money (which might or might not be for good reasons)?
--Will it prevent medications, including generics (which are rising in cost faster than most brand name medications) from becoming unaffordable, and thereby raise health plans' costs?
--Will it prevent health plans from restricting various services and medications from coverage, thereby raising the actual out-of-pocket costs of patients?
--Will it encourage more health plans to create competition and lower costs?
--Will it limit the definition of "acceptable" health costs to whoever is occupying the office of Insurance Commisioner?
--Will it just accelerate the control that Sacramento has over our health care?
--Will it just be another nail in the coffin of capitalism driving health care costs down (which, to be fair, hasn't occurred enough over the past few years, and is the ultimate reason Washington passed the ACA)?
--Will it just be another step towards single-payer health care, which some of us want and others don't?
Of note is that the Los Angeles Times, which is pretty sympathetic to all things liberal and government-run, is OPPOSED to Proposition 45. That says a lot about how far of a reach this proposition is.
For those who think it's delicious and awesome to have Sacramento and whatever serves as our current Big Brother run our lives and our health care, Proposition 45 will be wonderful and great.
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For the rest of us, whether we are unhappy with health plans, despise health plans, recognize the need to work with health plans, or who just want more competition, Proposition 45 is something we could really do without.
One can hate health plans (don't most of us, at this point?) and yet recognize that Proposition 45 is the wrong way to keep health care costs down.
Let's see if the Californian electorate this November will think with its head, and not with its gut, on the thorny, challenging issue of healthcare and our need to keep it truly, finally, honestly affordable.
(Ken Alpern is a Westside Village Zone Director and Board member 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 CD11Transportation Advisory Committee and chairs the nonprofit Transit Coalition, and can be reached at [email protected]. He also does regular commentary on the MarkIsler Radio Show on AM 870, and 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 12 Issue 82
Pub: Oct 10, 2014