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No going back to “the good ole days”

By Jack Bernard

Bernard is a retired corporate executive

The Hill (5-17-19) had a column which advocated abolishing insurance and having a direct contracting model. In fact, a decade ago, I had an oped in the AJC opposite the head of the Georgia Medical Association who was making a similar case. I agree that we cannot continue on as we are currently going. But disagree that eliminating insurance is the corrective course of action. I’m a capitalist, not a socialist. However, we simply cannot go back to the supposed “good old days” when physicians negotiated prices with each patient. Trading a chicken for an office visit is just not feasible in 2019. President Trump came into office stating that Obamacare was a disaster and he would provide lower cost, high quality healthcare for all.

Trump moves have increased the number of people uncovered by 1.3 million (2016-2018) while the number of Americans having access and cost issues has increased (Commonwealth Fund, 2-19). During Trump’s term, more Americans did not receive these types of services due to cost considerations: filling needed prescriptions; getting recommended tests; visiting MDs when ill; and getting needed dental work.

And, their mortality/morbidity stats are better, not worse. If the current multi-payer for-profit insurance system doesn’t work, there’s an obvious solution: single payer. Medicare overhead costs are much lower than private insurance companies (2 percent versus 12 percent). It’s one of the few instances where government intervention is not only effective in achieving the goal of universal coverage, it is more efficient. It’s not only right morally, it’s right from a universal budgeting standpoint. The only thing lacking is political will. We can thank the healthcare-industrial complex, their lobbyists and bought politicos in both parties for this situation. Unfortunately, improving access while restraining cost increases and improving quality is virtually impossible under the current national political scenario. In the meantime, we must live with what we have in our healthcare financing world and improve upon it in our state. However, Gov. Deal refused to take federal funding to expand Medicaid, even though the first 3 years would have cost the state nothing at all. Despite his shortsightedness, 450,000 Georgians are now covered by the ACA.

Still, Georgia still has one of the highest uninsured populations in the nation (267,000 Georgians). Instead of just expanding Medicaid (90 percent paid for by the Feds), Kemp has applied for a 1332 Medicaid waiver, restricting coverage for the poor while increasing paperwork (see https://coverga.org). Comments can be submitted at stateinnovationwaivers@cms.hhs.gov. Let’s hope that after the poorly handled COVID-19 crisis, Kemp will finally wake up to the need to expand the ACA to cover the maximum number of Georgians…rather than just furthering right-wing ideological goals.