Are we ready for 30 million people to go back to using the ER for health care?

by Lonnie Palmer

Republicans are fond of saying that Obamacare (The Affordable Care Act or ACA) is on life support when the reality is that in 2013 health care spending grew at the slowest rate on record since 1960, according to the Centers for Medicare and Medicaid Services which tracks health care spending.

While Obamacare has its flaws, slowing health care spending growth is no small feat. (In fact, it might just fall under the category of a miracle.) Not only that, there are tweaks to the law that will fix Obamacare without sending the 30 million people now projected to be covered by Obamacare in 2017 back to the ER for health care.

And these tweaks would be significantly less expensive and less disruptive to the health insurance and medical care markets than Republicans’ plan to repeal, delay and replace Obamacare. (Beware of any plan with the word delay in its title. The “delay” means the “planners” have no idea what they are going to do.)

The easiest fixes for the ACA involve getting more young healthy people to purchase health insurance on the exchanges and finding more creative ways to deal with those more risky health insurance purchasers with pre-existing conditions including age-related chronic health problems.

The following are four tweaks that would bring solvency and expanded coverage and better cost control to Obamacare:

1. Increase the amount of the penalty paid by the uninsured on their income taxes.

2. Increase the maximum differential (the higher cost paid by older, sicker clients).

3. Create risk pools for sicker enrollees and have the government subsidize the cost of health insurance for theses enrollees and have the government backstop the potential insurance company losses for these high risk enrollees.

4. Allow pre-existing condition enrollees who are rejected by insurance companies and potential enrollees in geographic areas with insufficient health insurance exchange participation by private insurers to enroll in Medicare regardless of their age.

All of these potential solutions or any combination of them would minimize disruptions to our existing health care and health insurance networks and maintain the gains we’ve made in controlling health care costs and extending health insurance coverage to more US citizens.

The Republicans’ present plan to repeal the ACA, delay until they find an answer and then replace the ACA will fill up our hospital emergency rooms and waste money that should be spent on preventive health care.

Not only that: Does anyone think that repealing the ACA, eliminating Medicaid expansion and eliminating or reducing the government subsidies for health insurance will improve student achievement? More poor children living in families without health insurance or not having health insurance themselves will mean more chaos in their lives and more hurdles for them to overcome in school.

Even the best schools can’t overcome all of poverty’s ill effects. Do we really want to expand those ill effects when the global economy requires a better educated workforce. This looks like a penny wise and pound foolish errand the Republicans are about to initiate.

Let’s get the ideology out of our medical care and health insurance decisions and make some practical decisions that help us all. The options are right there in front of us. Why would we go with any other solutions?

About Lonnie Palmer
Lonnie Palmer is the author of the solutions-based book “Why We Failed: 40 Years of Education Reform.” click here






Author: Lonnie Palmer

Author of the solutions-based book "Why We Failed: 40 Years of Education Reform"

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