Let me be clear. I do not prefer the Affordable Care Act (ACA, Obamacare). There are much better options.
All you need to do is to research health care in other developed countries. Take your pick: single payer (Medicare for All, my preference, like in Canada); multiple payer utility model (in France, think GA Power and REA); and direct government provision (in Australia, England and our own VA).
But choosing among these three better alternatives is not the decision that faces us in the short term. The current choices are (a) defund the ACA and convert Medicare into a voucher program, per Ryan; (b) go back to where we were in 2008, with a broken system and more uninsured every day; or (c) fully implement the current law of the land, the ACA.
The GOP, my party, is intent on repealing Obamacare and through the House keeps pushing this course of action (40-plus times so far). The Ryan proposal would cap federal expenditures, but do nothing at all to restrict the growth of health care expenditures overall.
What about option b, going back to where we were in 2008? There are 48 million uninsured people living in this nation and that is a national that all citizens should decry. Many are the working poor. Some are older people who have lost their job and are unable to obtain coverage at a reasonable price, or at all if they are ill, under the current system.
What insurance company is going to voluntarily accept a 60 year old man that has had multiple heart attacks, diabetes and other medical problems? And, if they actually do, what will the premium have to be for them to make a profit? The ACA mandates coverage for all, relying on a tax to force everyone to get insurance and, therefore, spread the risk.
Plus, when I first became Director of Health Planning for Georgia in 1976, health care spending as a percent of GNP was 8%; now it is 18% and rising. That is not a course that is sustainable for the long term. Although I have my doubts as expressed elsewhere, at least the ACA makes a limited attempt to address this issue, setting the stage for much more effective measures in the future via single payer.
So, given the three current choices (vouchers, existing system, ACA), I believe that the U.S. is much better off with the ACA than without it. Is the ACA the perfect solution? No, there is no perfect solution anywhere in the world, although other nations are better at it than we are. Our biggest short-term issue now seems to be politics.
Along those lines, all Georgians should roundly condemn Insurance Commissioner Ralph Hudgens' recent remarks and actions. For those of you who have not followed this embarrassing situation as reported in this paper and on national media, Hudgens said that he would actively oppose Obamacare at any cost.
He has made good on his pledge by making sure that only one "navigator" is licensed to help our citizens figure out how to actually obtain coverage through the state insurance exchange as set up by the Federal government (due to Georgia's refusal to do it). The Feds goal was to have 100 licensed in Georgia before Oct.1, 2013.
It appears that in the states which have dedicated themselves to making the ACA work, the exchanges are valuable and workable, if not perfect. It is up to Georgia to either join in or risk becoming the laughingstock of the nation.
Jack Bernard, a retired senior executive for several national health care corporations, is also the former Director of Health Planning for the state of Georgia and former chairman of the Jasper County Republican Party; Bernard_Jack@hotmail.com.