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May 31, 2014
Repeal the
Affordable Care Act
Kathleen J. Burch, Psy.D.
Editor:
“The Bureaucrat Sitting on Your Doctor’s Shoulder” was a great,
first-person account of some of the life-and-health-threatening
consequences of top down, command and control health care. As a
psychologist, I know the damage done to health by destroying the
doctor-patient relationship; and as a consumer, I share Dr. Pollard’s
frustration. A podiatrist prescribed orthotics to treat my
bunions. Medicare would not cover the orthotics; it would cover
surgery, which was not indicated and which would have had a price tag
many times higher than the orthotics (not to mention the risk, the
pain, and the weeks-long disability attendant upon bunion surgery.)
The root of the problem is government interference in a sphere totally
out of its legitimate purview. Law of post-World War II vintage
that allowed employers to provide--tax-free-- employee health insurance
as a hiring incentive, was the beginning of the disconnect betweenlthe
health care service and the price. As the insurance companies
grew their business and offered more and more “benefits,” patients no
longer had a need to know prices, shop for the best price, or negotiate
with the physician. This lack of a financial contract between
doctor and patient has been the main driver of the incredible upward
spiral of health care prices. In contrast, the charges for
elective procedures, such as cosmetic surgery, not covered by
insurance, have remained stable or fallen under pressure of competition.
The government casts “greedy” physicians, other health care
practitioners, and pharmaceuticals and medical equipment producers as
ready to bilk the public unless they are regulated. Now, instead
of greedy physicians, we have greedy bureaucrats and attorneys at the
trough. We also have, as the article implies, great incentive for
fraud.
The answers seem clear, if wrenching to many of the entrenched:
first, repeal the abominable “Affordable Care Act;” next, remove the
tax advantage for employer-provided health insurance and expect that
people behave like grownups and purchase their own health
insurance. In this case, health insurance would quickly revert to
what the name says, rather than remaining what it has become: a
third-party payment system that incentivizes price inflation. The
prices of health maintenance and non-catastrophic care would fall to
what the market would bear. The costs of health insurance plans:
ditto. Other details, such as providing a safety net for those
who are chronically in need and uninsurable, could be worked out.
Kathleen J. Burch, Psy.D.
Dayton, OH
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