So-Called ‘Obamacare’ Is Not Socialized Medicine

I read with interest the Aug. 18 piece by Sherman Frederick on the ill-conceived Patient Protection and Affordable Care Act, also known as Obamacare, and how wise it would be to go back to the old system, which he described as “highly functioning.” As a former newspaper publisher, he described the new system as “socialized medicine,” which is a misrepresentation clearly intended to be inflammatory. Words do matter.

I had a career in health care management during a span of 35 years, and I am not a liberal or a Democrat.

Those are terms generally associated with advocates of Obamacare. I have seen our health care system at work firsthand at several levels, and I have seen both the best and the worst of it. I support the notion we have the best health care in the world for those who have access to it and can afford it, but we are far from having the best health care “system” in the world.

If we did, the per capita cost of care would not be double or triple that of other industrialized countries, key health outcome indicatorswould not be mediocre when compared to other countries as it is now and all citizens would have reasonable access to care without that access meaning a trip to the ER for routine care for some people.

In the U.S., people with good insurance usually get excellent care, and the system works for them, although it still encourages treatment of sickness rather than promotion of wellness. The system works also reasonably well for people at the other end of the spectrum: those with low or no income who rely on Medicaid. The people in between have more to worry about.

The system in place prior to Obamacare did not work well for people who could not purchase health insurance due to a pre-existing condition or who were dropped froman insurance plan by an insurance company without cause. Nor did the system work for people older than a certain age needing insurance but not yet eligible for Medicare. Many people whose coverage was through their employer had no choice except to stay in their job rather than retire early or change jobs for the sole reason they needed health insurance that would no longer be available to them.

Only in America is bankruptcy due to unpaid medical bills so prevalent.

Many people, includingthose with insurance, have been just one illness or accident away from personal financial disaster. The need for serious reform of the health care system became clear to me during my many years of observing what the system in place could do to good, thoughtful people who thought they had adequate fi nancial security.

Having said all this, Obamacare has fl aws. Of course any new law of this magnitude has fl aws. Rather than trying to repeal it or defund it and go back to the “good old days,” ourlegislators should take steps to improve the law while maintaining the key pillars necessary to make the system work. Like most complicated legislation, it had flaws in its initial passage, and there have also been many things learned since passage of the bill that were not known at the time that could lead to improvements.

Obamacare is not socialized medicine.

Socialized medicine means health care facilities and other providers are owned or employed bythe government and all decisions are made by the government. Obamacare is not set up that way.

The government provides policy, direction and some financing, while private insurance companies, hospitals and practitioners operate most of the system.

There is some degree of socialized medicine already in existence in the U.S., and it serves specifi c purposes. Examples include the Veterans Administration and the military health care systems. Interestingly, over the years these systems have worked well for their constituencies and also have also worked cooperatively with the private health care system in areas such as medical education and research.

Our health care system is in transition. It would be a lot smoother and better if experts representing all viewpoints and political leaders would work together on a bipartisan basis to improve our system to make it the best in the world. Going back to the old system is not the solution.

TOM O’NEAL IS A RETIRED HEALTH CARE EXECUTIVE WHO LIVES IN BELLA VISTA

Opinion, Pages 13 on 09/08/2013

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