By Peter Galuszka
As the right wing echo chamber continues to crank up after the botched launch of the Affordable Care Act, here are a couple of items that direct us back to reality.
One gives us a picture of how the U.S. really compares with comparable advanced countries with universal or near-universal coverage.
The other, an op-ed by three Democratic governors in Washington, Kentucky and Connecticut, notes that their states actually had a fairly successful launch of Obamacare because they pro-actively helped it along instead of taking every chance to throw spanners into the process.
In the first story, The Commonwealth Fund has released its annual survey of how 11 advanced countries rate in medical access, cost and affordability. Here the salient points:
- In 2013, more than one-third (37%) of U.S. adults went without recommended care, did not see a doctor when they were sick, or failed to fill prescriptions because of costs, compared with as few as 4 percent to 6 percent in the United Kingdom and Sweden.
- Roughly 40 percent of both insured and uninsured U.S. respondents spent $1,000 or more out-of-pocket during the year on medical care, not counting premiums. High deductibles and cost-sharing, along with no limits on out-of-pocket costs, may explain why even insured people in the U.S. struggled to afford needed health care, the researchers said.
- Nearly one-quarter (23%) of U.S. adults either had serious problems paying medical bills or were unable to pay them, compared with fewer than 13 percent of adults in the next-highest country, France, and 6 percent or fewer in the U.K., Sweden, and Norway.
- About one of three (32%) U.S. adults spent a lot of time dealing with insurance paperwork and disputes or were either denied payment for a claim or paid less than expected. Only 25 percent of adults in Switzerland, 19 percent in the Netherlands, and 17 percent in Germany—all countries with competitive health insurance markets—reported these problems. U.S. insurers spent $606 per person on administrative costs, more than twice the amount in the next-highest country. Such high costs result from a complex, fragmented insurance system, the researchers write.
- The vast majority (75%) of U.S. adults said their health system needs to undergo fundamental changes or be rebuilt completely.
- The U.S. spends $8,508 per person on health care. That is nearly $3,000 more per person than Norway, the second-highest spender.
So, no matter how much Obamacare critics, in some cases rightfully, criticize the launch and execution of the reform, it is crucially important to remember where we were at launch.
Speaking of launch, Govs. Jay Inslee, Steve Beshear and Daniel P. Malloy of Washington, Kentucky and Connecticut report that the problem today isn’t merely non-working websites. People are signing up for expanded care because those states laid the groundwork for the reform. They expanded Medicaid benefits and helped create exchanges for people to buy plans. They write that their states “have avoided the temptation to use health-care reform as a political football.”
Not the case at all in Virginia where Obamacare is most definitely a political football, albeit one played by a team as lousy as the hapless Washington Redskins.
Outgoing Attorney General Kenneth Cuccinelli – the failed gubernatorial candidate – has done everything in his power to make the ACA fail. He was one of the first attorneys general to sue to get rid of it and kept coming on even after the U.S. Supreme Court passed most of the law. He tried to create a myth of massive Medicaid “fraud” by setting up special investigative units to pounce. He perhaps should have spent more time on a real issue, such as rooting out conflicts of interest and ethics problems in state government in some cases where he was very much a player. His refusal to resign as attorney general while running for governor has helped rack up extra legal bills of more than $500,000 for taxpayers in the Star Scientific and ChefGate scandals.
Meanwhile, Republican Robert F. McDonnell likewise has done everything in his power to ensure that the ACA never gets off the ground. No state exchanges. No support on extended Medicaid coverage. The State Corporation Commission punts on its role.
Both politicians have delivered on their roles as spoilers so the Fox News-Jim Bacon echo chamber can reverberate with how bad it all is with truly ludicrous statements such as the worst legislation in the nation’s history.
As they pingback, little is done to improve America’s embarrassing ratings among advanced countries. Once again, the goal here is not to help the people or even government bureaucrats. The game is to back up Big Managed Care, Big Pharma and Big Hospital who provide the Big Money to Congressmen like Eric Cantor, the House Majority Leader.
Nothing is going to get better until the wrecking crew is disbanded.
