This article is a continuation. Click HERE to read part 1
…… What happened to the Affordable Care Act that made it so un-affordable for so many? What stood in the way?
First, Ted Kennedy became very ill with a brain tumor and subsequently died. Healthcare’s hardest worker, most effective and ardent supporter was not there to champion the changes that needed to be made.
COSTS and POLITICS: Doctors conflicts of interest: 94% of all physicians accept consulting fees and free samples and that amounts to 7 billion for pharmaceutical reps and 18 billion in the form of free samples to doctors. Hospitals and insurance companies provide enormous salaries to their top executives which are not often publicized. However, because of a SEC lawsuit, it was publicly released that United Healthcare paid their departing CEO over a Billion (no that is not a typo dollars in his severance package.
Sixty votes were needed in the Senate to pass the bill establishing ACA and that left those designing the plan open to blackmail from Senators that wanted something special in the bill for their state. As an example, the Indiana Senator wanted the medical device tax lowered as there were device makers in Indiana. Drug companies, the medical device industry, and the “non-profit” hospitals leaned on the Senators in their states to exempt them from cost cutting that was needed to make the plan affordable. It needs to be said, “non-profit” hospitals are anything but; they are big businesses and in some states the biggest with huge profits. Steven Brill gives one example: University of Pennsylvania Medical Center in 2009 had an operating profit in excess of 580 million and the chief executive officer took home four million in compensation. Every Democratic vote was needed to pass the bill, so no Senator’s demand could be ignored.
The lobbyists really went to work, one example AMGEN, the drug company that wanted protection for their name brand drugs, delayed acceptance of generics and protection for their super expensive biologics spent more than 38 million on lobbying in the three years leading up to the start of the ACA. This at the same time that the company was being investigated in fifteen states for questionable sales and marketing.
In addition, the Republicans were determined to stop anything the new president submitted and they are traditionally opposed to big government programs. It should be noted that the ACA was modeled after plans that were proposed by Nixon and Johnson and passed by Romney.
RESULT: Americans cannot import their drugs from other countries, Medicare could not negotiate drug prices, no cuts in Medicaid payments, biologics are protected for twelve years; and thanks to the Supreme Court, namely John Roberts, there is no individual mandate. The whole idea of insurance is sharing the risk. We all pay into the pot and when one of us gets sick the insurance pays for our treatment. Those young people who don’t want the insurance do have accidents and someday they will be old and the next generation will subsidize their insurance premiums.
To be continued…