Their View We need to reform—not scrap—the ACA


Election Day may be more than a year away, but the presidential election season is gearing up as Democratic candidates scramble for their share of media attention. In their quest to capture the spotlight, candidate after candidate has released their respective plans to fundamentally transform America’s health care.

Despite their differences, each of these so-called plans would lead us down a dangerous road to a government-run health care insurance system that would mean higher taxes, diminished access, and lower quality of care for all Americans. A recent government agency report indicated that Medicare-for-all would mean an increase in cost, by as much as $36 trillion, over a ten year period. This is not the way to improve health care in our country.

Obviously, the ACA is not perfect — far from it. Low reimbursement rates and the use of gold plans have created a system in which out-of-pocket costs are too high for average Americans to affordably access the care they need. However, scrapping the ACA entirely and replacing it with a government-controlled health insurance system would be a tremendous mistake — and would do nothing to address the high costs of care.

It really doesn’t matter what name you call it — Medicare-for-all, Medicare “buy-in,” a public option, or single-payer—the fact is that expanding the government’s role in health care will inevitably mean higher taxes for Americans and increased premiums in the private insurance market.

Medicare and Medicaid provide invaluable services for elderly, disabled, and low-income families; however, they are also programs that are already at risk. While some aspects work well, others are in dire need of repair in order to ensure they remain strong and secure for future generations. Massively expanding Medicare through risky, government-run options before stabilizing it could cause the entire system to collapse, threatening care for the tens of millions of Americans that currently rely on it.

In order to bring costs down, without raising taxes or jeopardizing access to care for anyone, we need to focus on doing what we can to improve the ACA by building on and expanding the programs and provisions that are currently working well while fixing what is broken. Practical fixes for the ACA — including state expansion of Medicaid, an increased focus on enrollment and education, and strengthening the marketplace through cost-sharing subsidies and reinsurance to lower premiums—can help us achieve this goal in a pragmatic, commonsense way.

I attended a State of the State message provided by then Governor Kasich. He had a statistic that was so over the top that I thought it was worth fact checking. He said that 5 percent of Ohio’s Medicaid recipients use 50 percent of Ohio Medicaid dollars. It turns out that the statistic was not only true, but was similarly high throughout most of America. Further checking indicates that the dollars are mainly not due to abuse of the Medicaid system. It is mainly our inability to manage the care needs of individuals suffering from numerous chronic conditions and elderly that can no longer care for themselves in their own home environment. There are numerous ideas and demonstration projects addressing these issues. Implementation of some of these ideas could make a sizable reduction in Medicaid spending and improve the health status of these two groups of people.

As president and CEO of Wayne HealthCare, I am most concerned with how these misguided efforts to increase government interference in the health care system will impact the rural Ohioans we serve. Accessing quality health care in rural communities in Ohio — and throughout the United States — is difficult enough given the increasing rate of provider consolidation. These problems would only be magnified if more hospitals, ERs, and other vital health care centers are forced to contend with drastically lower reimbursement rates under a Medicare-for-All or any other government-run system.

Most Americans do not want to see a complete upheaval of our entire health care system. They simply want our elected officials in Washington working together to build on and improve what we currently have—which is a system in which some 290 million Americans are covered. To do that, we must continue to increase competition in the free market so more people have choice and control over their health care coverage and the care they receive.

Moving toward a government-run health care system will do nothing to help meet these goals, and will only serve to make the problems we currently face that much worse. The Democratic presidential candidates—and all our leaders in Washington—should keep this in mind as they search for solutions to reducing costs and expanding coverage for more Americans who need it.

By Wayne Deschambeau

Contributing Columnist

Wayne Deschambeau is president and CEO of Wayne HealthCare and has been a fellow in the American College of Healthcare Executives since 1991. He is past- chair of the Ohio Hospital Association’s Small & Rural Hospital Committee, and was recently named as a member of the National Advisory Committee on Rural Health and Human Services.

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