senior scribes
May 31, 2014

Repeal the Affordable Care Act
Kathleen J. Burch, Psy.D.


“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

senior scribes
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