By Pam O’Dell
Regular readers know that I have written extensively on the Patient Protection and Affordable Care Act.
As a result, I have been barraged with both questions and strong political commentary.
During the course of reading everything I can get my hands on (including major parts of the bill) and talking to experts on the law (as well as
political operatives on both sides) I have made every effort to remain neutral.
I remain committed to report ‘just the facts’ but will, on occasion, summarize and review those facts. It is my hope that it will add to readers’ comprehensive understanding.
Here are a few points I want to make. These are not necessarily my opinion, but observations of what is likely to happen.
The PPACA is the law, much of which has already been enacted. In its entirety, it is not going to be repealed, dismantled, or even unfunded.
It is an unwieldy, complex, broken system that has created winners and losers. It is, in part, socialized. But it had to happen. The former healthcare system (which was also socialized) failed to address the needs of the nation’s working poor and allowed for unprecedented greed (most notably by the insurance and pharmaceutical industries) nearly bankrupting hospitals, businesses, and Medicare.
The new system is going to work, eventually.
While politically motivated, the law was developed by competent economists and health experts. They have done major (experimental) surgery on our nation’s healthcare system. During the experimental surgery, they have had to make some educated guesses.
Everyone involved was well aware that the system will need continual revision and it will never be perfect – nothing this large and complex can ever be locked into place without flexibility – new technologies, new trends in treatment and even new health crises (obesity epidemic, rise in diabetes type of stuff) will insure constant flux.
Working to make America’s healthcare workable will require the sacrifice and resolve of the American people - and a different attitude both in Washington and Atlanta.
When the U.S. Supreme Court ruled that states could opt out of expanding Medicaid, they did so as a principled decision based on the U.S. Constitution. Within that realm, I am convinced that decision was correct. However, from a policy standpoint, it amounts to an unfortunate set back.
I did not say disastrous. I said unfortunate. The health care system as currently affected by the PPACA will limp along in states with relative affluence and in urban environments. That will not be the case in Georgia.
With almost 20 percent uninsured and cuts to hospitals already in the red, Georgia is at the mercy of its governor, Nathan Deal, to allow the law’s original framework to be tested. If Medicaid is not expanded, the system, and, patient care, will suffer.
In Deal’s decision to opt out of the Medicaid expansion (and accompanying national media statements), I can see neither the sacrifice, nor resolve necessary to begin health care reform. He has cited the costs of expanding Medicaid, without citing the costs of not doing so.
According to reports in national media, the healthcare changeover has gone very well in both California and Kentucky where states were receptive and open to the change and handled website sign-ups at the state level.
PPACA opponents refute claims of obstructionism with statements about how the law is going to cause a destruction that they don’t want to be part of. This is akin to throwing the football on the ground when your team has the ball and expects you to make a push for the endzone.
A better attitude might be -- run any course you want, just run towards the goal, in this case a better healthcare system. No one, fifty years from now, is going to check the ball for finger prints. We will all, however, remember the defeat.
The demographics of healthcare (which involve more people on Medicare) as well as the economics (high unemployment and low productivity) are against us in Georgia and many areas of the country. These facts should cause us to understand that sacrifices are going to have to be made.
Yet some of us are angry and confused at a dysfunctional website and fixated on the fact that less than 4 million insured people may lose their sub-standard health insurance within a market that turns over annually.
If that causes us to squeal, we better just hold on. It’s gonna be a bumpy ride- and no one rides for free.
The website will be repaired and functional eventually. People will switch insurances. Sacrifices will be made.
Health reform advocates tell me that the PPACA will iron itself out.
This is a lie. Unchecked, it will expand and rob us all of our prosperity.
Ardent opponents tell me that the new law has created a system which will collapse on its self.
This is a lie. It is the same broken system ostensibly changed to be more equitable and control costs.
The new healthcare system must be checked, changed, and re-checked. Much like a buying a car, regardless of the initial quality you still have to perform maintenance. And, sometimes, if you don’t have the gas, you can’t ride.
[O’Dell provides news on state government through, The O’Dell Report in newspapers in North Georgia and her blog, odellreport.com. She can be contacted at