The Tribune Democrat, Johnstown, PA

October 29, 2013

Jim Scofield | Criticisms of new Affordable Care Act


JOHNSTOWN — It’s difficult to reconcile all the loose, thoughtless talk going against the Affordable Care Act (Obamacare). It ignores the obvious advances of the act. This new law covers preventive care (vaccinations and check-ups, among others), bans exclusions or pricing based upon pre-existing conditions or sex (women have often been charged more), includes children up to 26 years of age, has no lifetime cost limits, and bans dropping policyholders if they become sick. These are big advances, some of them already in effect.

Under the law, most coverage won’t change, whether in employer plans, Medicare or Medicaid. However, this new plan should cover 32 million of the presently 45 million uninsured Americans. Most of these are of medium income. And most will be eligible for subsidies to reduce their costs.

The exchanges are already offering better rates, according to recent reports, than private insurance have offered.

A recent Associated Press article in The Tribune-Democrat (“Republicans shifting target to ‘Obamacare,’ ”

Oct. 21) describes a self-employed photographer’s who sees he has better choices under the new law. Older than 50, with pre-existing conditions, he’s been uninsured for about a year. Yes, he did have problems with the government health care site, and does see some shortcomings. But he has been better able to browse the options on the site than he could before with private insurance applications, and he has been able to apply for a tax credit to reduce his premiums.

In contrast, Fox News’ Sean Hannity presented three couples who claimed vaguely that their insurance would be more costly or complex under the Affordable Care Act. They were obviously uninformed and hadn’t investigated the plans, as was Hannity, too.

The small businessman among them, with four employees, claimed erroneously that the act prevented his hiring more workers. He didn’t seem to know that businesses with less than 50 employees (96 percent of all businesses) don’t have to offer insurance at all. However, if they voluntarily want to offer employees health insurance, the small-business exchanges will allow them to pool their risks to get better rates (like corporations already do).

When Salon reporter Eric Stern talked with the other two couples later, he showed them that they would be entitled to plans with much lower costs. Most of the criticism of the act is similarly uninformed.

Will enough eligible healthy people sign up to make the system work? Insuring my house helps those unfortunates whose houses burned down, though I’ve gotten no return on my payments. All insurance depends upon having subscribers who don’t receive much return.

Considering the protections afforded under the Affordable Care Act, though, it would seem foolish not to sign up. Most people are liable to need care of one kind or another, and over the long haul are in jeopardy. Many uninsured have been bankrupted by medical costs, or at least owe large, insurmountable bills that undermine their credit.

Republicans in Congress want to overturn the new health care law, keeping tens of millions without insurance. They have no real alternative plan. Mitt Romney, as the Republican presidential candidate, was forced to renounce the successful medical insurance plan he got passed when he was governor of Massachusetts, even though it is very like the current Democratic plan and has worked well, covering most people in that state (only 2 percent there lack insurance). It, like Obamacare, requires all adults to obtain insurance.

All other wealthy nations insure everyone as a matter of course. People in those nations are healthier, and the costs there are substantially below what Americans now pay for our inadequate coverage. We’re supposed to think, erroneously, that they don’t have their own doctors, are pushed through some impersonal bureaucratic system and wait forever for treatments.

But health plans in those countries are popular. Those without adequate insurance here suffer much more, and our present system has some of the same deficiencies attributed to other systems.

In many Republican-controlled states, including our own, the Affordable Care Act’s extension of Medicaid, the insurance for poorer Americans, is being rejected. Why improve the health of the “undeserving poor” seems to be the idea. Over a half million Pennsylvanians are being left out of coverage under Gov. Tom Corbett’s decision to not extend Medicaid here. Corbett says he suspects potential recipients aren’t willing to search for work, even though 80 percent of them are children, seniors or disabled. This is just one example of how many states and many Republicans are working to keep millions of people uninsured.

Jim Scofield of Richland Township is a professor emeritus of English at Pitt-Johnstown.