Affordable Care Act is grounded in principles once endorsed by GOP
By Michael Pramenko
Guilty. Guilty as charged.
After my recent columns describing the benefits of Colorado’s upcoming health insurance exchange, I was accused of partisan cheerleading. Here is my mea culpa.
True, I purposefully highlighted two partisan elements of the Affordable Care Act. More specifically, my latest columns defended the individual mandate and the new health insurance exchanges.
Indeed, both of the concepts originated from the Republican side of the aisle. So, please excuse my partisan bias and my apologies to all the liberals out there that would prefer a single-payer system.
Colorado’s version of a health insurance exchange passed through the Colorado Legislature two years ago in bipartisan fashion. At that time, Republicans in the state controlled the House. And, long before it became law here in Colorado, the concept of a health exchange was regularly touted as a principle component to Republican plans for health reform.
The individual mandate has even more impressivee Republican origins. Starting out in 1989 at the conservative Heritage Foundation, the individual mandate was once used regularly by Republicans as a reasoned alternative to the health reform plan proposed by then President Bill Clinton.
Here’s the deal. There remain two legitimate models that allow for our fellow Americans — who either can’t afford insurance or are too sick to obtain it — to qualify for insurance:
✔ A single-payer health care system.
✔ A private system with subsidies to address the affordability issue and guaranteed issue requirements to ensure pre-existing health conditions can’t be used by insurance companies to deny coverage.
Critics of both choices should be consistent with their politics and policy. If you don’t want either of the two options, then should you not be advocating for removal of access to America’s emergency rooms for those that can’t pay for the service? No money – no care.
As I have written repeatedly over the last five years, America’s emergency rooms are the most expensive “universal” health care system on the entire planet. We are all paying for their overuse via increased insurance premiums. In effect, this is a “tax.”
A reformed health care system will guide people away from expensive emergency rooms for non-emergency care to patient-centered provider clinics. The individual mandate and the insurance exchanges move our health system in that direction.
Access to affordable health care should not be considered a liberal idea. It’s a human idea. It’s an idea consistent with advanced civilization. It’s an idea endorsed by the American Medical Association, Colorado Medical Society, Club 20 and numerous other organizations in Colorado.
Finally, don’t take my word for it. Check out the following excerpt from an opinion piece written by J.D. Kleinke of the conservative American Enterprise Institute. His opinion piece in The New York Times last Sept. 29 included this observation:
“The core drivers of the health care act are market principles formulated by conservative economists, designed to correct structural flaws in our health insurance system — principles originally embraced by Republicans as a market alternative to the Clinton plan in the early 1990s.”
The concepts are solid — we are wasting time on politics. We should be focusing our current efforts on fixing the real Holy Grail of any health reform plan — cost control. Certainly, excluding people from health insurance and access to care is not the answer.
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.