To Steve Lunetta:
Regarding the Saturday column “Some sound bites on health care,” I found your article and the research to be quite interesting, but hearing only from the opposite sides of the political spectrum is unlikely to uncover facts and data that we can rely on.
I am surprised that the left-leaning Commonwealth Fund is actually “crazy for the ACA.” I would certainly expect them to defend it as opposed to the GOP Senate and House plans. Most liberals are still pushing for universal health care, which the ACA has never really approached, nor will it unless bipartisan legislative corrections are pursued in Congress.
Improvement will require an innovative and difficult decision to embrace a public option in individual insurance markets, which are becoming devoid of competition.
Medicare for All (in the individual market) but retaining the employer-provided coverage for the large majority of Americans might be another approach. Medicare for All could be introduced to replace the coverage for low-income users of the Medicaid system. Medicare does require a Part B and D contribution, unlike the free Medicaid coverage.
This seems to be a more practical solution than insurance coverage for health care, which will price sick people out of care while selling useless but cheap policies to the young and healthy. Additionally, medical cost controls must be instituted, including negotiated prices for prescription drugs, in order for universal coverage to be affordable.
As for the right-leaning NCPA (funded by the Koch brothers), which suggests that the U.S. should look at the Switzerland model, this is fantasy thinking. The economics of our two countries are too different. Whereas the Swiss have a relatively small population of poor and low-income citizens, the U.S. has over 45 million on food stamps.
Many low-income Americans cannot afford to purchase insurance policies even if mandated by law. This Swiss model is completely unworkable without significant government assistance for low-income Americans and those disabled (such as in nursing homes).
As for the GOP plan to “cut” Medicaid costs by slowing the growth of Medicaid by imagining a low rate of inflation in health care (as opposed to the historical trends), this is just foolhardy. Suppose that a state or region has $100 million in costs for Medicaid in 2017, and the growth in medical costs is 7 percent over 7 years.
This will inflate to over $160 million in this period of time. If the inflation rate is assumed to be a low 2 percent, as the GOP might envision, the cost will inflate to less than $115 million in costs. The missing $45 million will be reflected in less medical care and poorer outcomes for the poor and disabled.
Nothing in the GOP plan is going to improve health care coverage nor reduce the rate of inflation of medical costs. The reality is that we are going to deal with budget-busting deficits unless bi-partisan practical solutions are enacted.
Both political parties must be invited to the table, along with the medical institutions and providers, plus insurance and pharmaceutical businesses. Congress must immediately cease the practice of conducting legislation in secret sessions without public hearings. This is unbefitting of a true democracy.
Thomas Oatway is a Valencia resident.