I need to respond to a letter regarding uncooperative Republicans and Obamacare. Obamacare was passed by a Democratic controlled Congress that gave special favors/exemptions (bribery to the rest of us) to get their own members cooperation. The majority of leaders in the Democrat and Republican parties are more interested in keeping or getting their own party in power than trying to fix our countries problems. I am not a member of the Republican party. I have supported candidates from both parties. I have an underlying requirement of fiscal responsibility, which currently rules out most Democrats.
The letter writer believes that the government programs of Medicaid, Medicare, and Social Security help the poor. I know that these programs help. I've had over 25 years of practice experience with Medicaid, Medicare, Veterans Administration, Rural Health Clinic, private practice, charity clinics, and other programs. These government programs are very inefficient and do not always help those in need. A study in Oregon showed that Medicaid spent 15 percent more to receive the same outcomes. If you don't believe me, ask any physician, social worker, nurse, or others that deal with these programs if they can be improved.
The VA and Obamacare control costs in the same way. They decide what is "cost effective" and will not cover anything else. This is fine if the covered benefit works for you. If not, you are out of luck. This is one of many reasons that people from England, Canada, and all over the world come to the U.S. for healthcare. The government, in collaboration with the AMA, set up the dysfunctional payment system that we have now. I disagree with the suggestion that the government will pay fairly and make things right.
Medicare and Medicaid rates are unilaterally imposed on doctors and other healthcare providers, whose only choice is whether or not to accept any Medicare or Medicaid patients. In the future, health care providers may not have that choice. The only choice then will be whether to continue practicing medicine. Don't forget, Obamacare allows for 1,600 IRS agents, but no more physicians.
There were several ideas the government could have used to help people. They could have made personal health care expenses fully deductible. They could have allowed health care providers to deduct the amount that people claimed they were unable to pay and then had the IRS validate those claims; instead they plan to turn the IRS loose on everyone. The government is further limiting what you can pay for with your medical benefits card and giving special breaks to big business and union health plans only, so much for helping the little guy.
Several studies have shown that tort reform could save over $500 billion a year, yet this is nowhere to be found in Obamacare, so much for claiming to want to save taxpayers' money. Could the reason be that the trial lawyers and their association are the largest donors to the Democratic Party? The government spends $3 for every $2 it takes in. Obamacare does not make health care more efficient or less costly. Going ahead with a poorly designed program making things worse, not better, is not the right thing to do.
Richard E. Cain, MD