Healthcare Problems Before and After the Affordable Care Act

I am happy that I chose not to become a physician.

I am happy for a couple of reasons that shed light on America's healthcare systems. One is the high cost of extended education and training, compounded by the high cost of medical malpractice insurance. These can be overcome by working in places like Patch Adams's alternative medical complex in West Virginia and my best wishes and admiration go to all there.

Parts of the Affordable Care Act (ACA) can help physicians with these problems and offer care to larger numbers of people and I hope we keep those parts of the Act, even if we eliminate other parts.  Ohio Governor John Kasich is not yet sure if he will allow the implementation of ACA at all. My own opinion is that under ACA, some large insurance companies might lose money and that is the possible origin of some the outcry against ACA.

For myself, I have worked in therapy, health psychology and alternative medicine, saved many $100,000s for individuals in medical procedures like surgeries, and volunteered 10,000 hours in a recent twelve-year period of these services without receiving a thank you. A few paying clients did not pay and in fact, demanded more unpaid services and one of these people was a millionaire. However, the circumstances are much worse for a number of physicians I know, MD and DO, even Nurse Practitioners and Physician Assistants. These professionals volunteer heathcare services by turns somewhere every day of the week and do not always receive payment from paying clients. At least under the Affordable Care Act, these people are to be paid. 

The second reason for my decision to enter Preventive Medicine rather than Medicine is patient noncompliance, a major problem with providing medical care. Overall, the average patient will not follow instructions. He will not give the doctor the whole story of his medical background, nor provide a complete list of drugs and supplements that may recently have been in his body. In many cases, the doctor-patient relationship is adversarial, more so the dentist-patient relationship. This cannot help the patient. If the doctor must take an oath to do no harm, then perhaps the patient should take an oath to cooperate.

I remember hearing in public health classes about Traditional Chinese Medicine (TCM) customs in which patients go regularly to a doctor to maintain happy good health. They pay the physician as long as they stay healthy. When they become ill, the doctor pays them. Is this true? I really do not know, but I like the concept.

People argue about the Affordable Care Act of 2012. Some point out the negative results that may occur under its operation, while the other side yells, "BS!" They shout that the American public is too intelligent to believe the "bs" and too intelligent to believe that anything bad can happen under the new healthcare act. This is incorrect. 

Massive testing and analysis of the American population from school age through adult since 1993 show that the average reading level of America is only between grades 8 and 9. Unfortunately, much of our populace cannot understand the Affordable Care Act, much less the propaganda of political campaigns for president. 

Romance novels, selling billions each year, are written at the 6th grade level. Most weekly and hometown newspapers are written at the 6th to 8th grade level. Most Americans function at the 8th grade level in mathematics or below. Having taught GED, ESOL, high school work readiness, and adult college prep studies (e.g., SAT preparation) for years to1000s, I know these reported levels to be accurate. These functioning levels are not high enough to permit critical analysis of media news in Internet, TV, and magazine coverage, let alone the Affordable Care Act. Someone needs to publish an understandable interpretation.

For instance, very few have read the premium rate tables or know that four (4) levels of health insurance coverage are offered under the Act. An additional coverage is provided for catastrophic coverage only, likely to be chosen by young adults. Here's a real catastrophe: 

The lowest premium available to a person aged 60 under the ACA with an income of $55,000 annually is $10,172 with no subsidy available - that's almost $1,000 every month and 18% of total income.

That's what I will be looking at one day, because every employer of my last two decades dropped health insurance coverage. Not only have I not had health insurance for 85% of my life and gone on to donate 10,000 hours of healthcare without thanks and gone on to maintain a carbon footprint of only 25% of the average American, but in future, I'll be required to pay $1,000 monthly to pay for others' healthcare as well as my own.

I like the idea of heathcare accessibility for all, but why penalize working Senior Citizens? If anything will kill the work ethic among Seniors, this is it; but they must work, because companies lay them off in their early 50s while Social Security had increased retirement ages to 67, 70, and in future, 75. Since lifespan in America (only the 50^th longest in the world) is about 79 for male and female in 2012, what are Seniors to do for income between ages 50 and 75?  More sharply, if the average reading level is around grade 8.5 and health is declining rapidly in this country because of obesity-related and age-related conditions, then how can these people even think of starting a business to replace lost employment? 

Some voices scream, “There are no jobs!” Unfortunately, yes, there are no jobs for people that can read only at the 8^th or 9^th grade levels. New jobs emerging in and after 2012 require advanced education and licensing, being largely in healthcare, technologies, and aerospace fields.

Are hospitals legally required to treat people without insurance, as some talk show hosts maintain?  If so, then some are breaking the law that is unenforced. In Central Ohio since 2010, I have witnessed several uninsured people over the age of 50 as they were turned down for treatment in hospitals. 

Increasing numbers of our physicians are dropping and refusing new Medicare patients and that’s legal. Some refuse Medicaid patients, while other doctors state that they have never had a problem with Medicaid payment and would be glad to have more Medicaid patients. The Affordable Care Act is to increase consistency of payment through insuring more through Medicaid. 

At the same time, every yearly increase in Social Security retirement cash benefits that is approved is counteracted by a like increase in Medicare premiums. Perhaps Medicare should be folded into Medicaid. 

A local news report in 2011 stated that EMTs here in Central Ohio provide little or no service to individuals that appear to be over 50 years of age - I can't believe that. What's more believable is that after asking an older person if they want to go to the hospital, he or she replies no, and the EMTs leave, but I have no experience with this. More and more people never call for help at all, because the cost is currently $450.00 for an EMT visit here.

Parts of the Affordable Care Act are worth keeping and many Americans need the services promised by them. Incidents such as the GalaxoSmithKline fine of $3 Billion levied during the summer of 2012 for off-label drug marketing and physician bribery raise high healthcare costs even further as the fine is passed on to the consumer. If the ACA is not preserved in its good parts, then fewer people in the USA will likely be able to access healthcare in the future.