Lies, statistics and (somewhere in between) the truth?
With all of the media coverage surrounding the new Republican majority in House’s effort to repeal the Patient Protection & Affordable Care Act (“PPACA”), a great deal of information is lost in the noise surrounding the debate. Depending on your preferred news source, the PPACA is either a necessary step being taken to address the healthcare system in the US or it is a “job killing machine” that is unconstitutional and unwanted by the American people. As with most arguments of this sort, the truth lies somewhere in the middle of all of the shouting and rhetoric.
According to the center-right public policy institute, the American Action Forum, 695,000 jobs will be saved if the PPACA is repealed. According to the same group, repeal of the PPACA would reduce the federal budget deficit by $280 billion. That is in direct conflict with the non-partisan Congressional Budget Office. The CBO claims that a repeal would add $230 billion to the deficit. That is a remarkable swing of $510 billion dollars. It is roughly the equivalent of the discretionary spending for the following federal departments: Agriculture, Transportation, Interior, Veterans Affairs, State, EPA, Education, Energy, HHS, Labor, HUD, Homeland Security & Agriculture. That is a staggering list.
With such dramatic variances in the cost estimates of the PPACA, one has to begin to question the rationale behind these estimates and work to come to terms with them. The late Senator Daniel Patrick Moynihan is attributed the quote, “Everyone is entitled to his own opinion, but not his own facts.” Some might take that a step further and say that everyone is entitled to their own informed opinion. But that, too, raises a challenge given the biased news sources now prevalent in our society.
All of this leads to the reality that the issue of healthcare in America is a difficult one. I do not believe that anyone would argue that it is a good thing in our society to deny medical insurance to those with pre-existing conditions or for coverage rescission to be a common and acceptable business practice. It also raises the issue of whether or not the federal government can mandate that people participate in the commerce of buying insurance. Those are constitutional questions that will ultimately be decided by the Supreme Court, Congress or both. For the health care providers, all of this noise leads to great uncertainty and guess-work.
The American Hospital Association, the Association of American Medical Colleges, the Catholic Health Association of the United States, the Federation of American Hospitals, the National Association of Children’s Hospitals and the National Association of Public Hospitals and Health Systems all filed friend-of-the-court briefs in favor of the PPACA in a Michigan case challenging the constitutionality of the law. This would seem to fly in the face of what we hear from some members of Congress about the law’s unpopularity in the healthcare community. But it would also seem to indicate that all of these organizations, and likely most of their members, are planning on the implementation of the law in some form or another. And while the media noise surrounding the law may make for good theater, it is not helping our healthcare system prepare to provide or provide better care to patients now. And this is the real danger that is overlooked in this debate.
I might alter Senator Moynihan’s quote somewhat, everyone is entitled to their opinion regarding the law, but they are not entitled to affect patient care and its affordability just to score political points. We have a great healthcare system in this country. But it is only as good as the patients ability to afford to receive it.
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