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ALPERN AT LARGE - Of all people, one of the least-favorite Republicans on Capitol Hill is calling out her own party in not fixing the cost and operations of the Affordable Care Act (ACA), one Marjorie Taylor Green.
Meanwhile, the famous (infamous?) Scott Adams, beloved by many for his long-running Dilbert cartoon, and resented by many for his statements regarding race, has reached out as a Northern CA Kaiser patient who needs quicker access to a cancer drug to save his life…and he’s not alone.
And yours truly, doctor and CityWatch contributor, and former Neighborhood Councilmember and rail advocate for a good 20 years, still proclaims that we need better and more affordable health care, but the bill is DUE.
So we’re right back to where we are before the Democratic Party unilaterally passed the Affordable Care Act (“Obamacare”, as it’s also called) without a single Republican vote in Congress:
We STILL have issues with the Affordable Care Act being Affordable, being about Caring, and being about Action.
And if anyone reading or pondering this wants to blame this side or that, they certainly can, but he/she is being myopic and oversimplifying in doing so.
To those criticizing the Democratic Party for saying “DO SOMETHING” without knowing what they really did, the question of whether or not the GOP had ideas that were any better, and for all parties, must be raised.
In a nutshell, the ACA was a demand that all parties pay into the system, and it was written NOT by doctors and nurses but by health plans/insurance companies—and the Supreme Court allowed it because Congress CAN pass taxes on the American People if it so chooses.
And the ACA absolutely WAS a tax…make no bones about it.
Yet perhaps it was a NECESSARY tax, and long overdue, for each and every able-bodied American without health insurance to GET some, PAY for it, and KEEP paying for it every year.
Unfortunately, it was subsidized for many years, into the pandemic, and then beyond the pandemic by our last President.
So now, in the middle of a game of chicken by both political parties over SNAP benefits and benefits to illegal/undocumented migrants living here, the issue of confronting what the ACA did, what the ACA means, and how it’s meant to be fixed should be center stage.
Perhaps the answer must wait until this week’s round of elections to figure out which way the nation is going, and where its sentiments lie.
But honest issues are 1-2 decades behind confrontation and resolution, and here are a few:
1. We all deserve access to health care, but the question of whether everyone deserves the same access to an expensive and hard-to-access physician may not be so easy to figure out.
2. It’s too damned hard and expensive and loooooooooong to get into medical or nursing school, yet we have a horrific shortage of doctors and nurses—that needs to end.
3. We used to have lots of hospitals and other settings where overseeing faculty physicians and supervisors taught residents, and these residents oversaw and taught other residents below them on the totem pole, and we need to bring much of those programs back to bring health care directly to larger numbers of Americans.
4. Do Medicaid patients deserve the same direct-to-physician access as privately-paying American patients, particularly for routine conditions and treatments easily administered by trained physician associates (PA’s) and nurse practitioners (NP’s)?
5. Now that we will learn what the ACA really was, do we recognize that the ACAD model mirrored much of “socialist” Scandinavia (which is NOT as socialist we many presume it is) to DEMAND that more pay into the health care system?
6. Can the ACA premiums, which are going up big time for many of us, be means-tested better than they now are to reflect the ability of Americans to actually afford the Affordable Care Act?
7. Can we pursue more medical operations, oversight, and organizations run by practicing physicians and nurse managers WHO SEE PATIENTS?
8. Do those NOT here legally “deserve” access to clinics and hospitals funded by the American taxpayers, or is the time NOW for Democratic and Republicans states to find sponsors?
9. Similarly, for those who are able-bodied, do we demand and create matching jobs for law-abiding Americans to at least work part-time to be eligible for health benefits? Because in “socialist” Scandinavia, if you don’t work and you’re able-bodied, you do NOT qualify for tax-payer funded health services.
10. Finally: When will American medical systems and health plans become more open with their patients and make it clear that those who NEED more expensive health services are NOT always the same group as those who WANT more expensive health services…yet are not concluded by physicians as desiring services that are Not Medically Necessary.
Welcome back to the ACA debate, folks.
Maybe we can get it right this time.
(Kenneth S. Alpern, M.D, is a dermatologist who has served in clinics in Los Angeles, Orange, and Riverside Counties, and is a proud husband and father. He was active for 20 years on the Mar Vista Community Council (MVCC) as a Board Member focused on Planning and Transportation, and helped lead the grassroots efforts of the Expo Line as well as connecting LAX to MetroRail. His latest project is his fictional online book entitled The Unforgotten Tales of Middle-Earth, and can be reached at [email protected]. The views expressed in this article are solely those of Dr. Alpern.)
