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    ACA: It’s not what the doctor (or voters) ordered

    Natural consequences means allowing a behavior or circumstance to determine the outcome without other intervention. The American people have spoken. They are envious of the promise of socialized healthcare as  promoted in other countries such as Canada. Americans’ fantasy of Canadian-style “healthcare for all” is, in actuality, a two-tiered system. One tier is the government owned and run system with all its delays and access issues. The other tier is the direct patient pay system for people who want their care now and are willing to pay for it.

    The American people elected a Congress and a president who made this their goal. The “stakeholders” were at the table with lobbying money and powerful political favors. These groups included Washington politicians, the American Hospital Association, the Pharmaceutical Research and Manufacturers of America, the American Medical Association, the American Association of Retired Persons, the health information technology industry, big business, and unions, among many others.

    Notably missing were practicing physicians and patients. Each powerful entity got their paid politicians to write their own part of the law to get their “buy-in,” figuratively and literally. Congress passed the legislation, in the dark of night, without everyone reading the entire 2,800-page law.

    What American voters thought they wanted was a socialized health insurance safety net for all citizens. What they got was the Affordable Care Act, aka “Obamacare.” Instead of the government owning and operating the healthcare system, as in Canada, it has been sold to private corporate interests but with rules by government law. Hospital-owned accountable care organizations (ACOs) will dominate the landscape. Even the U.S. Supreme Court violated the constitution by upholding the mandate for each citizen to buy a health insurance policy that must conform to government specs, thereby costing more than plans do now.

    The consequences of Obamacare are now becoming evident. It increases the price of each insurance policy. Every citizen must buy a policy from an approved vendor or face a monetary penalty. Care will be rendered by huge hospital-centric ACOs that know nothing about efficiency, economy, cost-savings, or the practice of personal medicine. Hospital ACOs are investing millions in development in hopes of “shared savings,” from Medicare, Medicaid, and private health insurance plans. A Canadian style two-tiered system is forming that is resulting in similar issues of access, costs, and care delays.

     Americans, too, will be forced to choose between government promises of taxpayer-funded hospital ACO impersonal healthcare, or the direct patient pay model used since the beginning of recorded time. You can argue with natural consequences, but cannot escape them.

     

    Craig M. Wax, DO
    The author is a family physician in Mullica Hill, NJ.

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