[Occupymendocino] Affordable Health Care info

[John]

Single payer is the obvious answer. Insurance companies will do whatever it
takes to thwart Medicare for All. Be prepared.

 

 

From: occupymendocino-bounces at lists.mcn.org
[mailto:occupymendocino-bounces at lists.mcn.org] On Behalf Of Richard Karch
Sent: Tuesday, October 25, 2016 12:02 PM
To: occupymendocino at lists.mcn.org
Subject: [Occupymendocino] Affordable Health Care info

 

The New York Times

October 24, 2016

Why the U.S. Still Trails Many Wealthy Nations in Access to Care

By Aaron E. Carroll

 

Many are still unhappy with Obamacare.

 

The main intent of the Affordable Care Act was to expand the safety net
(Medicaid), regulate the non-employer-based private insurance market (the
insurance exchanges) and help people buy that insurance (subsidies) in order
to reduce the number of Americans who are uninsured.

 

On those metrics, it appears to be succeeding.

 

First and foremost, Obamacare was about improving access to health care.
While it did improve access to insurance, in many, many other ways the
United States is falling short. Things are likely to get worse before they
get better.

 

Even with Obamacare, the United States still ranks poorly among comparable
countries in insurance coverage. Even in 2016, when the rate of insured is
the best it has ever been in the United States, Americans still have a
greater percent of the population uninsured than pretty much any other
industrialized nation in the world.

 

Access is about more than insurance, though. Every few years, the
Commonwealth Fund conducts an international survey of patients. The last
time the fund fielded the survey was in 2013, and it sampled patients in 11
different countries, all of them on the high end of the worldwide
socioeconomic spectrum.

 

When asked if patients could get a same-day or next-day appointment with
their provider when they were sick or needed care, 52 percent of Americans
said no. This placed the United States next to last among these countries.
Only Canada (59 percent) was worse.

 

When asked whether it was "somewhat" or "very easy" to get care after
regular working hours, the United States placed eighth, beating France,
Canada (again) and Sweden. Because of this, at least in part, Americans are
more likely to use the emergency room for care.

 

Primary care physicians feel this pinch as well. When the Commonwealth Fund
surveyed them in 10 countries, doctors in the United States ranked ninth
(ahead of Canada) in being "well prepared" to manage the care of patients
with complex needs. They ranked last in whether staff made home visits. They
also ranked last, by far, in whether practices had arrangements so that
patients could see a doctor or nurse after hours without going to the
emergency department.

 

Why is this? One of the reasons is manpower. The United States, for all its
spending, has fewer general practitioners per population than any of these
other countries.

 

The biggest access problem in the United States is the expense of obtaining
care. More than one third of Americans said they did not fill a prescription
they were given, did not visit the doctor they should have or did not get
the tests that were ordered because of the cost.

 

Perhaps most telling, when adults were asked about their views of the health
care system in 2013, 75 percent of Americans said that it needed fundamental
change, or that it needed to be completely rebuilt. This percentage was
higher than for any other country surveyed, Canada included. Primary care
physicians feel similarly. Yet years after the Affordable Care Act was
passed, Americans are still litigating whether to return to the previous
system.

 

Access was a problem before. Access is a problem now. Americans can't seem
to have a discussion on how to make that better. Without that, it's hard to
see how things will improve.

 

http://www.nytimes.com/2016/10/25/upshot/why-the-us-still-trails-many-wealth
y-nations-in-access-to-care.html

 

===

 

 

Comment by Don McCanne

 

The point here is that, although the Affordable Care Act (ACA) did expand
the percentage of people with some form of health insurance, it still leaves
us worse off than other nations in the percent of individuals remaining
uninsured, and it didn't fix other problems such as impaired access to
health care.

 

Canada also scored poorly, near the United States, on some of these
measures. This is partly due to our similar cultures, and both nations need
to improve. In fact, Canada is making a concerted effort to address its
problems with queues. But it is important to note that this does not mean
that Canada's single payer system has failed them. Not reported here are
much more important measures in which Canada is clearly superior to the
United States as a direct result of their single payer financing system:
universality, equity, portability of coverage, elimination of financial
barriers through first dollar coverage, reduction of administrative waste
through public administration, and other efficiencies that have resulted in
much lower per capita spending.

 

This month there is a campaign to tout the successes of ACA in order to
reduce concerns about the announcement of the double digit increases in
premiums for the ACA exchange plans. But when you objectively evaluate the
successes, with the exception of the expansion of Medicaid, these
improvements are almost negligible when compared to the improvements that
Canada already has in place by virtue of the Canada Health Act that provides
support for the single payer systems in their provinces.

 

As Aaron Carroll states, if we want improvement, we need to have a
discussion on how to make the system better. Since ACA is falling so short,
that discussion needs to center around truly effective reform, including a
single payer national health program.

 

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