short-sighted politics,long-term problems;COLUMBUS JOURNAL ENQUIRER, Mar. 10, 2012

short-sighted politics,long-term problems;COLUMBUS JOURNAL ENQUIRER, Mar. 10, 2012.

COLUMBUS JOURNAL ENQUIRER
Saturday, Mar. 10, 2012

Retired Georgia health care exec says short-sighted politics will mean long-term problems in health care

By JACK BERNARD – bernard_jack@hotmail.com
My Republican Party has staked out a losing long-term position on health care reform: No basic change is needed, just let the free market reign.
That strategy has made for-profit people like me a lot of money in the past, although it has not solved the access, quality or cost problems endemic to our health care non-system.
This is not to say that “Obama-care” (the Affordable Care Act) is the right solution on the cost side, although it does help somewhat with access.
“Obamacare” requires that everyone buy insurance, with government supplements for the poor and lower middle class. A large portion of this financial burden will fall on already broke states via Medicaid. Further, this is America and it is yet to be seen how many young and healthy people will actually buy insurance, requirement or not. That is, if the Supreme Court finds the mandate to be legal when it looks at this topic in the very near future. The smart money says this highly politicized court will vote 5-4 to find the mandate unconstitutional.
“Obamacare” will thus ensure that the cost problem gets much worse, especially if there is no universal mandate and only the sickest folks get insurance. Simply adding people to insurance company rolls does not alleviate systemic problems, such as the counter-productive and illogical financial incentives under a fee-for-service rubric.
Insurance and pharmaceutical companies will make record profits, thanks to this supposed “reform,” with the public up in arms over corporate profiteering. Businesses will continue to cut benefits, shift premium costs to employees and be less competitive internationally. Health care as a proportion of GNP will rise even more rapidly.
The government will pay out more than it originally projected and see greater red ink along with growing deficits, while millions remain uninsured. The voter will see his/her premiums, co-pays and out-of-pocket costs rise dramatically (this has already started) as the insurance companies continue their historic practices and maximize their profits, the public be damned.
In the short term, the public is mad at the Democrats for passing the new ACA reform law. Longer term, with rising health care costs, the GOP will lose elections in which Democrats will blame the Republicans for stopping action on more comprehensive reform.
It is time we Republicans face the facts. Voters are tired of the same old worn-out GOP slogans: prevention, tax credits, and expansion of free markets. The health insurance market is different from others; pricing and quality data can never be readily available and understandable for the consumer. Free-market competition is not the answer unless the goal is to make insurance company executives rich at our expense.
The GOP should support nationalized health insurance, Universal Medicare, the same way we support nationalized VA health services. Yes, under Universal Medicare there will eventually be rationing to control costs, but isn’t that what we Republicans are supposed to do — control costs in a rational manner?
Short of redesigning our entire system to force everyone into some Clintonian capitated and integrated model, there is no workable alternative for long-term cost control. As the party of fiscal responsibility, we should know that and take the lead in bringing down expenditures.
As anyone who is in an HMO can attest, our current system already rations care, just not very well. Plus, studies have consistently shown that uninsured and underinsured Americans put off getting needed medical visits, procedures and medicines — in effect rationing their care.
In order to contain costs and keep U.S business competitive on the world stage, a single-payer system will eventually be adopted, probably in another 20 years or so and no doubt over loud Republican opposition. We can either get behind Universal Medicare now, getting credit for advocating for real reform, or wait a couple of decades and get it anyway.
Jack Bernard, a Jasper County commissioner and former chairman of the Jasper County Republican Party, is a retired executive of for-profit health care services. He is now a private consultant for small business.

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