The Patient Protection and Affordable Care Act (PPACA) really should not be called Obamacare, if anything it might be called Romneycare as Romney pioneered such a healthcare system in Massachusetts before Obamacare came into being. I’m afraid the association of the act with Obama has made people believe it’s a segue towards a socialist worker’s paradise; and soon we will all cared for by the nanny state from cradle to grave. Whether you think the socialist state is a good or bad idea, it’s important to understand that Obamacare and socialism have about as much in common as corporate CEOs and welfare queens. Actually that is a terrible comparison, because Obamacare provides new ways for healthcare CEOs to behave like welfare queens only with astronomically higher amounts of wealth.
At first glance, if you listened to the rumors while PPACA legislation came in, you might think this was a plan to extend affordable healthcare to every American, which sounds like a socialistic ideal. Unfortunately, the plan will leave about 23 million Americans with no health insurance, and many more so underinsured that if they ever get seriously sick, they will end up bankrupt. While increasing premiums and deductibles for some hard working people, the plan will add millions to the overflowing coffers of insurance and pharmaceutical industry companies. Such companies were already some of the most profitable companies in the entire world. It’s important to realize that the PPACA is neither socialistic nor capitalistic; rather a handout to existing insurance companies, essentially an adventure in corporatism.
When I studied Political Science courses as an undergraduate I learned of a political spectrum with right and left. Occasionally the word authoritarian came in as an adjective. The word corporatism was never mentioned once. We need to develop a new language to understand what has happened to our democracy. Governments can be classically conservative or leftist but it does not seem to correlate to how authoritarian or libertarian they are in reality, or as importantly for us now how much they have been hijacked by corporate interests. In the US corporations and their oligarch rulers have seized the reins of power, and only lip service to democracy remains. In 2010 the CEOs in healthcare make a median paycheck of 10 million dollars a year, bonuses not included. Their salaries and bonuses have continued a mindboggling ascent. Can we really claim these billionaires have equal political power to nurses who may make $60,000 a year, let alone a poor unemployed patient? Empirically it would seem otherwise. The healthcare companies employed such a large army of lobbyists to work on our government that the lobbyists outnumbered actual congress people by a ratio of 6 to 1. There is no final count on how much money greased the wheels of “democracy” around the ACA, but there are records of how much money different industries spend on lobbying. According to The Center for Responsive Politics, the pharmaceutical and health product companies lead the pack in paying off, or put more politely, lobbying the government: with expenditures of over $2,795,344,315 on lobbying alone since 1998.
If you are curious what all this money is buying for you, the answer is nothing. You personally, unless you are a high ranking government official or healthcare executive will get only a more painful existence thanks to all this money changing hands. Unfortunately even if you cannot pay to play in terms of creating legislation, healthcare law will still affect you and everyone else. You may be well off enough to buy your own care, but it won’t stop you from being forced into risks inherent in our unbalanced system like of catching infectious diseases from the poor, and the USA is leading the first world nations in terms of this health metric. Few other wealthy countries have our burden of tuberculosis or chlamydia for example. We are also number one or close among highly developed nations in teen pregnancy, drug addiction, obesity and gun violence. At the end of the day doctors here are justifiably overwhelmed.
The question of how to create a better system has yet to be answered. We are Americans, a unique nation, and we don’t have to copy from everyone else. We can lead innovation in healthcare delivery if we choose. But right now we are innovating in ways no sane people would want to imitate. A few brave voices have come forward asking for a real conversation about the issue. Some of us want healthcare informed by a conversation between healthcare providers and patients, instead of a conversation between government bureaucrats and corporate oligarchs eager to line their pockets. One such effort towards a more real conversation was undertaken by my colleague Dr. Ronit Lavie, who carefully read the PPACA, thought up some better ideas, and tried to start a national conversation. For years her website www.medicalreforminitiative.org was not visited by many, possibly reflecting the high levels of apathy endemic in our population.
Doctors want to take care of patients without bankrupting them in the process. I personally volunteer with patients every single month. I can tell you firsthand there are patients suffering from health insurance issues today in the US, and Obamacare is not making these problems disappear. Most doctors are decent people who can and will do patients a favor in a pinch; but we need a favor back. We need you to get involved and pressure our government for a better healthcare system. . Help us get a system where we can heal patients without sending them to bankruptcy court. Help us get a system that does not throw most of us into 6 figures of debt just to earn an MD, which then creates pressures on us to take up high paying jobs that might not even have to do with real patient care. Help us be able to give all patients the medicines they need. In short, help us serve YOU better. Get involved because we as patients and in some cases healthcare providers need to put ourselves at the center of the healthcare debate.