One Response to “Opinion: Affordable Care Act Consolidation Increases Health Plans’ Market Power”

1. 

   November 21, 2016

   Joseph Mooney MD, MBA, FACEP Reply

   At this point in time the bad actors in all of this are the CMS and the Insurances. We in the EM field are really sharp end of this inequity in health care coverage. Due to present legislation we see all comers, obviously the more insured the better ( as they say in the business, ‘self pay’ equals ‘no pay’). However, it would seem that although the ACA may have been well intentioned, it was still a bandaid to a already mortally wounded creature. Maybe our efforts should be toward a restorative solution to healthcare, both in cost and scope. I am not opposed the a single payer system ( although I doubt that it would be single, as seen in several countries that have a national systems) but I am only one and this is a nationwide issue. Present remedies to healthcare have been presidential decrees, politically motivated incomplete fixes that have been applied, however seem only to shift the holes in care. I am also not sure that the present patrician mandates that the government have in place and keeps expounding, are anything but propaganda as none tackle the issues to definitively repair of the problem. When I last looked at the cost of healthcare, a few years ago it, was up to 2 trillion dollars annually and the governments healthcare safety net, The Medicare Trust, had been in warning for a couple of years as the principle had been breached each year. At this cost, this is a national issue, and corrective measures may need a more defined approach. To that end, why not an amendment to the Bill of Rights to include healthcare. Although not specifically mentioned and unlikely to have been included as such in this document,( health care wasn’t something anyone wanted at that time as, well..it wasn’t of good or of value) and support an amendment specifically for health care. I believe such a move would be warranted as nationally we could clearly say how we want tax dollars to be spent towards our healthcare. I think that it would be beneficial to the citizenry to cut the cost of care. Either way, I believe that the costs would be greatly improved. With a national system, there would less gray area and cost and services would be more inline with a market economy where users and payers directly interact. The non-payers would vanish, as either it is all covered or if you can’t afford it, you don’t get it. I am not saying that physicians would be better off, as I don’t see that going forward in any of the present scenarios. I think that this is a downward slide for us, from our independence in the past to our earning potential, whatever course is chosen. However it turns out, it would be the people who decide and a mandate for a definitive plan would be made clear, not the present minimalist approach by the political machinery that only makes it appears that they care about the issue!