Almost every small business owner with whom I have come in contact over the past few months has expressed deep disdain about the same thing, Obamacare. They say things like, “Obamacare is keeping me from expanding, from growing my business, and from making any money.” What went wrong? Why did this effort to do so right end up going so wrong for the small business owner?
Dr. Donald Berwick, one of the primary architects of the Act, had a long history of working for the people. It was my honor to meet Dr. Berwick while he was the President and CEO of the Institute for Healthcare Improvement, a not-for-profit organization dedicated to utilizing evidence-based medicine and research to improve the quality, safety and cost of healthcare. He is a genuine, caring physician who has dedicated his life to attempting to fix the most expensive, and in some ways least effective, healthcare system in the world.Before you get upset about the last statement, let me explain that we are great at what I call train wreck medicine. There is no country in the world that is better at dealing with major traumas, heart attacks, neonatal births, brain surgeries and the like. Where we fall down is in the area of population health. We do not emphasize wellness and prevention. That is one reason why nearly one-third of the United States is either diabetic or pre-diabetic.
In 2010, Barack Obama appointed Dr. Berwick to serve as the head of the Centers for Medicare and Medicaid Services. The ACA had three main objectives: expand access to health insurance, protect patients against capricious activities by insurance companies, and reduce costs. The State of Massachusetts under their Republican Governor Mitt Romney, had introduced a health insurance program that was a compromise between a single payer, socialized medicine-type program and a managed care, insurance-company-based program. The Obama administration believed this compromise would result in two distinct opportunities: 1. The Republicans would support it. 2. The insurance and pharmaceutical companies would not attempt to block passage of the program.
On December 2, 2011, Dr. Berwick resigned because of substantial Republican opposition to his appointment and his probable inability to be confirmed by the Senate. As of 2015, twenty-two states are locked into the politics of opposition, states that primarily have Republican governors who have rejected Obamacare. This political decision has left millions of their own people uninsured.
The only way this program will work is similar to the manner in which car insurance works. Here’s the formula. Everyone has to have car insurance to drive. The majority of accidents are, however, caused by younger drivers. Consequently, older drivers are subsidizing the costs of those accidents. In Obamacare, the reverse is true. If there aren’t enough younger people in the Obamacare program, the risk pool will not be large enough to sustain the program and the costs will continue to escalate.
Because twenty-two states didn’t participate, and the Supreme Court ruled to allow states to reject Medicaid for their poorest (roughly 7 percent of the population or 5.9 million people), the anti-Obamacare states (red states and some swing states) are able to deny health insurance to their constituents and thereby make the law seem very unfavorable. Add to that the health insurance companies that are now dropping out of the program because the pool is not big enough.
What’s good about it? Insurance companies can’t keep you from getting insurance because of a preexisting condition. Your children can stay on the family policy until they are 26, and millions of people who never had insurance can now get insurance. The bad news is that it needs more work and co-operation to get it right. And that is one reason why Obamacare is struggling and why costs are skyrocketing. Because of redistricting over the past thirty years, politicians don’t have to work together anymore. And that is sick.
I think he made a good job, surelly he cna do much better but in every country is not easy to made changes and needs much more time to do it.