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Hopes for dismantling the Affordable Care Act

By Ed Dawkins
I would be negligent, in my role as a physician and social caregiver, not to comment on our current medical politics predicaments, Obamacare and its spin-offs. The following is a personal letter from me to my old friend (Putah Creek Council start-up days), Joe Krovoza of Davis, when he was running for the California State Assembly in 2013:
“Joe, I looked up your statements on the Affordable Care Act and don’t agree with a single payer (federal government) system. I spent many months as a hand surgeon treating and teaching around the world as a professor-consultant in hand surgery (six months in South Africa, almost four months in NZ, a month in Nigeria, a year in Panama), all wrapped around my private practice in Davis.
“I was also an Assistant Clinical Professor at UCD med school for 25 years and ran the initial Sacramento-area hand clinic when it was still named the Sacramento County Hospital. I’ve lectured nationally and internationally on medical politics. I was an original board member of the Sacramento Medical Foundation that set up Medi-Cal in the ‘60s.
I have seen and worked in several socialized medical systems and traveled for a week with the heads of the Australian and British Medical Associations. When I was drafted during the Viet Nam war, I ran the hand center for all of New England — Army, Navy, Air force and Marines. I had residents helping, and when I left after two years, there were 50 inpatients and many hundreds of clinic patients.
I’m going on too much — but the point is that I’ve been around the block a few times and have had a chance to look at health care from many sides, including a month doing lecturing and surgery, at hospitals in Eastern Europe (Hungary, the former Czechoslovakia, Romania) and Russia.
“Joe, of course I realize — and that’s another story — that our medical system in the US needs drastic reforming. The good part of the Affordable Care Act is that we are being kicked into reform, at last. But it’s going to be a long nine years (the whole induction process of the ACA) before the government has us at its complete mercy.
“Our only salvation is to get a competitive, less mandated, less lawyered system with a stable safety net and reasonable hospital costs. This will be much better served by the private sector with competition driving costs down and medical care up, and doctors making health care
decisions, not bumbling bureaucrats. There is so much hidden frustration and inefficiency lurking under the muck of the suddenly and badly and inexpertly drawn up document — by politicians that are under-informed and don’t know what they’re doing — in page after page of the ACA.
“There will be increased costs, with less and inferior care, long waits and politicians making bad decisions that hog-tie over-worked and under-paid and under-appreciated medical professionals into uncaring lethargy. Our presently superior (to the rest of the world), creative medical technological edge will be dulled.
“Here’s my sum-up of the ACA (Obamacare):
“A disaster! Health reform is needed, but not by clueless bureaucrats. Twenty percent of our economy would be nationalized with increased costs and decreased care and long waits for everybody — all of this overshadowing the increased coverage for the poor, who could be included in a much less expensive way and much better (for them) system.
Thanks for listening.”
Readers, it’s now February 2015, over a year after my letter to Mr. Krovoza. Here are some new hopeful thoughts for the coming partial or complete dismantling of the ACA, as presently written.
I want to talk about writer Steven Brill (“America’s Bitter Pill”), who has been extensively involved in writing and talking about a better way to look at constructing a newly changing health care system in America. His book was reviewed in the Jan. 5 edition of Time Magazine and he had the cover story in the Jan. 19 edition: “What I Learned From My $190,000 Surgery.”
He knowledgeably discusses the pitfalls of the ACA and the implementation of good solutions, by having competitive, large medical centers and hospital units do their own insurance, cutting out the insurance company middle-man and with doctors being in charge of patient decisions. The signed-up patient would be able to go anywhere in the system.
Brill points to huge health care savings and better and more efficient (and non bureaucratic-directed) patient care. I recommend reading these articles. I’m sure they will be enlightening.
The world is changing, and we-the-people have to make our own judgments and adaptations, guided by those who are experienced in putting people’s needs first with creative out-of-the-box thinking. Change is everywhere. Vive la difference — let it keep coming.