TUCSON — in the spring issue of the Journal of American Physicians and Surgeons, Jane M. Orient, M.D., writes that efforts to repeal the ironically named Affordable Care Act (ACA or “ObamaCare”) are proving very difficult, as the system has become entrenched over the last 7 years. The foundation is unsound, she states: ACA is based on “forcible redistribution of wealth and the concept of ‘comprehensive coverage’ as the most favored way to pay for medical care.” But most of the “healthcare delivery system” is grounded on the same flawed premises. About 90 percent of the “healthcare dollar” passes through a third-party payer, she notes.
As with a structurally unsound building, the first priority is the safety of the people inside it, Dr. Orient suggests. Those who can leave the third-party arrangement—ACA plans, Medicare, Medicaid, commercial managed-care plans, etc.—must be allowed to do so without penalty. And alternate models must be allowed to develop, she states.
“In a free market, many different structures are built, without governments, think tanks, or advocacy groups dictating the plans. Innovation of course cannot be predicted or forced to happen. The government’s job is to make and enforce fair, reasonable, predictable rules that foster innovation and competition.”
Pre-existing conditions are a problem, she notes, partly because of government policy. But they are by nature uninsurable, and guaranteed issue “leads to a ‘death spiral’ in voluntary insurance when low-risk people refuse to be overcharged to cover those at high risk.” Another way to finance care—as opposed to “coverage”—must be found.
Attempts to save ACA and the rest of the system by tweaking are like piling on more of the lead bricks that are now staving off the collapse of the Leaning Tower of Pisa, Dr. Orient states. We don’t want another centrally planned replacement for a tottering tower. “The legacy we want to preserve is the one of freedom, which brought us prosperity and wonderful advances in medicine.”
