After years of bewildering debate, the federal health care reforms derided as “Obamacare” are finally upon us.
Diehard opponents have spent the past two years casting futile votes against the signature achievement of the Obama administration. Now they seem determined to climb to the walls of their political Alamo at least one more time, threatening to shut down the government unless the administration abandons the plan to provide affordable health care to some 32 million uninsured Americans.
Granted, the Affordable Care Act remains a partial, flawed solution to an enormous problem. But the biggest problem arises from the failure of the reforms to control inexorably rising health care costs, not in the health insurance mandate or the expansion of coverage.
We suspect the confused and bitter opposition to the program will dwindle when people actually get a chance to sign up. The reforms build on the insurance-based system already in place and harness competitive, free-market forces by setting up exchanges that enable people to actually shop for insurance.
So far in states that have set up those exchanges, the array of insurance plans offered cost about the same as insurance plans on the market now. That experience contrasts sharply with opponents’ claims the cost of coverage would explode.
In truth, valuable requirements that policies cover pre-existing conditions and impose no lifetime limit on the cost of coverage will probably result in increased costs. But then, the insurance mandates and premium subsidies will bring millions of healthy people into the insurance pool, which should mitigate those increases.
Moreover, the significant subsidies should make insurance affordable for millions of Americans — including thousands of Gila County residents. Please note, Gila County has among the highest rates of the uninsured in the country — with 30 percent of residents already on the Arizona Health Care Cost Containment System. Starting next month, people can shop for insurance through the federally managed health care exchanges.
The reforms should save lives. One study by researchers from the Harvard Medical School concluded that roughly 60,000 Americans die prematurely each year for lack of health insurance. At minimum, the reforms will save thousands of lives each year, while ensuring that more people pay into the insurance pool. Right now, many people gamble on not getting health insurance, get sick or injured, lose everything — then turn to the taxpayers for help by signing up for AHCCCS once they’re bankrupted by their medical bills.
Of course, the reforms won’t solve the deeper problem — the shocking cost of our medical system. Figures compiled by the 34-member-nation Organization for Economic Co-operation and Development (OECD) noted that the U.S. spends 18 percent of its Gross Domestic Product on health care. We spend $8,233 per person, about 2.5 times as much as other, advanced countries.
Despite that expenditure, the U.S. has 2.4 doctors per 1,000 people compared to 3.1 in the 34 OECD countries, which includes almost all of the other advanced industrial economies. We have 2.6 hospital beds per 1,000 population compared to 3.1 in other advanced countries. Our life expectancy is one year below the average for comparable countries.
The International Federation of Healthcare Plans also reported some sobering comparisons when it comes to the costs of various procedures in 25 industrialized countries. Every year, costs in the U.S. outstrip any other country. An angiogram that costs $35 in Canada costs between $173 and $2,430 in the U.S. The report gave a single cost for the single-payor systems in other countries but offered a range of costs in the U.S. because of the enormous variation here. The doctor’s fee for a routine visit costs $30 in Canada and France but between $68 and $176 in the U.S. The cost of an angioplasty in the hospital totals $7,564 in France, $8,910 in Australia, $6,332 in the Netherlands, $14,000 in the United Kingdom — and between $17,000 and $62,000 in the U.S.
The enormous cost of the system remains the single greatest threat to the economy and the solvency of both the state and federal governments. The token cost-control measures in the Affordable Care Act have been derided as “death panels,” a measure of the political bankruptcy of the system.
So please, let’s move on. Let the reforms take effect, then work on solving the remaining problems.