ACA may need tweaks, but it’s doing what it’s supposed to

By Michael J. Pramenko

The month was August 2009. It’s been five years since President Obama came to Grand Junction to highlight some of the successes of the Mesa County health system. It’s been five years since the Democrats angered half of their own constituency by compromising on health reform legislation.  Remember, that month the Senate Democrats agreed to Republican demands to leave out a public option for health insurance as they crafted the Affordable Care Act.

There is even something more remarkable, but not at all surprising. Congressional Republicans have yet to vote on any alternative health reform legislation since the Affordable Care Act passed in 2010.

It’s amazing, yet predictable all at once. Through all the grandstanding and cries of economic catastrophe, through all the trench warfare politics and over 50 votes to overturn the Affordable Care Act, Americans have yet to see a bona-fide alternative to the president’s controversial legislative victory.

Nearly three elections later, and after multimillion dollars worth of Koch brother anti-Obamacare advertisements, we still do not know how Congressional Republicans stand on pre-existing health conditions and methods to help uninsured or underinsured Americans.

Congressman Scott Tipton, speaking to representatives of the Mesa County Medical Society last fall, promised that alternative legislation was coming. Moreover, he promised help for physicians dealing with a nearly two-decade old problem with how the government pays physicians in the Medicare system.

What did physicians get from Scott Tipton? Not only have we not seen any alternative approach to health reform, but he sided with the “dysfunction express” when he used his vote to help block a bipartisan solution to the physician Medicare payment formula earlier this spring with just another temporary “patch.” 

With another election coming this fall, I wonder if our local news, editorial boards, and citizens will question the empty health reform plate served by Congressman Tipton and his colleagues in Washington D.C.

Furthermore, with compromise so sorely needed in Washington, how can Scott Tipton explain his failure to help physicians fix Medicare’s payment system? He used this important issue as just another opportunity to attack the Affordable Care Act.

Like Congressman Tipton, we do not hear as much from the Republicans or Fox News these days about Obamacare. Maybe it’s the 10 million newly insured Americans. Maybe it’s the stories of families finally being able to afford health care. Maybe it’s coverage for pre-existing health conditions. Or maybe it’s just the simple fact that after all these years they still don’t have an alternative solution to the problem.

Here in Colorado, the uninsured rate is down by an impressive six percent and fewer Coloradans are showing up at hospitals without insurance. That will lead to significant savings for those of you with insurance.

Progress continues. There is momentum from state government on new payment models within the Medicaid system. Innovative pilot programs within the Affordable Care Act are strengthening primary care practices. And, the overall momentum to curb the rising cost of health care is helping spur new conversations on health reform programs right here in Mesa County.

Health care in America was on life support.  While the Affordable Care Act needs some work and refinement, it has begun to address the major problems. Certainly, it’s better than five years worth of political grandstanding and empty promises.

Michael J. Pramenko M.D. is the executive director of Primary Care Partners. He serves on the Club 20 Health Care Reform Committee and is a past president of the Colorado Medical Society.


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The combination of the Daily Sentinel’s scathing editorial (“A challenge for Tipton”) and Dr. Michael Pramenko’s surgical critique of Tipton’s perfidy (“ACA may need tweaks, but it’s doing what it’s supposed to”) affords ample evidence that Tipton’s ideological commitment to the extremist “Tea Party” agenda ill-serves the interests of the 3d C.D.

Today’s editorial chronicles Tipton’s disingenuous pandering to an ill-informed but vocal local anti-government minority that opposes re-designation of the Colorado National Monument as a National Park, dishonest reinforcement of the “false impression that park status poses a regulatory threat”, and “empty claims” that re-designation “could adversely affect the local economy” – when he knows full-well that quite the opposite is actually more likely (given his own family business’s proximity to Mesa Verde National Park).

Dr. Pramenko’s commentary documents both Tipton’s false promise to local doctors to support a permanent “fix” to Medicare’s inadequate physician reimbursement schedule and the sorry fact that Tipton then “used his vote to help block a bipartisan solution”.

Such despicable duplicity is what we now expect from Tipton, who (like fellow “Tea Partier” Cory Gardner) voted 50+ times to repeal, replace, or defund the Affordable Care Act (“ACA”) – while cynically embracing FoxNoise’s “ObamaScare” misinformation. 

The ACA benefits 24 million Americans, including 400,000 Coloradans (and – as of last Thursday—500,000 Pennsylvanians), but Tipton/Gardner obviously don’t care.

Meanwhile, House Republicans like Tipton/Gardner can offer no genuine alternative to the ACA because – as Dr. Pramenko aptly notes – the ACA is already “conservatives’” alternative to the “single payer” approach preferred by “liberals”.

“Tea Partiers” opposed a permanent “doc fix” because it would cost $130 billion over ten years.  Thus, rather than raising the revenues needed to address the real problems facing our Nation, Tipton/Gardner hypocritically regurgitate the empty rhetoric of their already thoroughly discredited “anti-tax” ideology.

Replace them – not the ACA.

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