In this election year, health reform may be biggest issue

I have always been somewhat apolitical, never registering with either major party, spreading votes among both, and even others occasionally. And I realize that many people feel strongly about their political positions these days. Still, it seems to me that life goes on regardless of who gets elected. I am more comfortable focused on pragmatism, what will actually work, than any political ideology.
I do care about the future of our health care system though, and in this political season, reform is at the core of the public debate.
From my perch inside the health care system and my active role in the reform debate, I can see how precarious a future we face. What we decide politically could make a great difference to the sustainability of health care as we know it.
As a businessperson who understands and believes in both the transformative power of free markets, but also how corrupt they can become, I am amazed to hear political hopefuls cast the current reform law as a government takeover of health care. It couldn’t be more the opposite – really.
The Patient Protection and Affordable Care Act or Affordable Care Act, or Obamacare, is nothing if not a free-market approach. Just a few years ago an essentially similar plan was known as the Republican option. There isn’t even a “public” option in it, which many thought necessary to balance the leverage of insurers.
Its main provision for cost control in fact calls for the establishment of health-insurance exchanges. If anything, these marketplaces should act to enhance and enable competition. If they work as planned, they should bring transparency to a now confusing morass of choices, allowing consumers to make rational choices based upon their individual needs and values.
By consolidating individuals and small groups into larger groups that can shift market share substantially, they should elicit aggressive bids, squeezing much of the overhead from a bloated model, and helping to reduce costs the old-fashioned way. The exchanges, however, won’t free employers from the cost of the benefit in the short term. But coupled with necessary reform of the tax treatment, they could allow companies to provide a voucher of sorts to employees that would be redeemable at the exchange. Ultimately this rebalancing of the wage/benefit equation could enable a transition away from the employer-based system, which never made much sense to me.
Why should my company be making a single health-coverage choice for hundreds of people, all with varying needs? Why should someone who loses their job also lose their health coverage? Isn’t “individual responsibility,” which clearly would be a lynchpin of the new system, a conservative mantra?
Oh! But there would be subsidies for folks with low incomes, you say? True enough, otherwise they wouldn’t be able to afford coverage, which is precisely why there are 50 million uninsured today. But in Obamacare the subsidies are paid for.
There are give-backs by insurers and providers, and even taxes on medical manufacturers and importers like our firm. We may not like them, but most of us in the industry would rather pay than face the calamitous system failure that appears almost at hand. In a sustainable system, we can figure out how to restore profitability over time. In the chaos of a failed market, we could all perish.
Even in our tiny state, we already have two hospitals in receivership, add one or two more, which is distinctly possible, and you will start to see their creditors and suppliers, many small, local businesses, go with them.
I understand how conservatives chafe at the very idea of “entitlements” like Medicaid, and now the Supreme Court has given states the option to opt out of the expansion of the program that would enable the new subsidies to buy coverage.
Some states have vowed to do exactly that. What a myopic blunder that will be. If ever there were a more graphic example of cutting off your nose to spite your face I can’t think of it. Medicaid is already a good deal for the states and the ACA makes it even better with all of the increased Medicaid costs coming from the federal government in the first few years. Even in the current system, the feds pay more than half the cost of the program. And the money flowing in from Washington stimulates local economies, provides jobs, builds gross state product and enhances local tax revenue.
Of course, if what the conservatives are really saying is that we shouldn’t be providing health care to people who can’t pay, that would be a different argument. Tell me you want to repeal the decades-old federal law that requires hospital emergency rooms to treat everyone who shows up and then just let the uninsured bleed to death outside the doors, and I would have to concede you at least make an intellectually honest case, even if you realize it is so massively inhumane you could never get it passed.
But to foster a position where the burden of caring for the uninsured is borne almost exclusively by providers and businesses that buy private coverage, rather than spread among all taxpayers, is simply a ruse I’m not buying. You aren’t arguing about who should have health coverage in a system where we treat everyone, you are only arguing about who pays for it, and I presume you mean not you.
Whether you call it the Affordable Care Act or Obamacare, the law is the most significant progress we have made in health care reform in my now-long, Medicare-eligible life. I knew when I started writing that I wouldn’t change any votes among the devoted on either side, but perhaps if you are undecided or otherwise open-minded, I would hope you would choose candidates who support the hard-fought progress in health care reform we have made. &#8226


Ted Almon is president and CEO of Warwick-based medical supplier Claflin Co.

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