Two perspectives on the flawed Patient Protection and Affordable Care Act:
Kay Tillow of the All Unions Committee for Single Payer, writes that despite all the hoopla surrounding the passage of PPACA, the law will still leave tens of millions uninsured.
More than a year after President Barack Obama signed the Patient Protection and Affordable Care Act into law, our nation’s health care delivery and coverage remain the disgrace of the industrialized world. There are more than 50 million uninsured Americans. Even if the health care overhaul works as planned, 23 million Americans will still lack health insurance in 2019.
The new norm is underinsurance. About 40 percent of us go without needed care because we can’t afford it. The health care law won’t change that, even once it’s completely phased in. Our plague of medical bankruptcies will continue too.
For unions, bargaining for health care is getting tougher as employers demand cuts and shift more costs to workers. Negotiations over better health coverage will become almost impossible when the excise tax on health benefits begins in 2018.
Many who saw the reform bill as “the best we could get” are disappointed that support for it hasn’t grown. The truth is that most people agree on the reform law. They love the parts that block insurance companies from denying coverage and care. They hate the parts that give away our tax dollars to insurance companies. They hate the mandate that will force everyone to buy insurance from the very companies whose profit motive is the source of most of our health care system’s problems. They hate the escalating costs of insurance and care.
Only a single payer system can bring us the parts we love and do away with the parts we hate.
And, insurance industry whistle blower Wendell Potter exposes how the insurance lobby isn’t wasting any time pushing hard on the White House to further weaken PPACA.
One example: a section of the law expanding the rights of consumers to appeal adverse decisions made by their health plans.
“The Affordable Care Act will help support and protect consumers and end some of the worst insurance company abuses,” read an Obama administration fact sheet from last summer.
The fact sheet went on to assure us that the new rules would guarantee consumer access to both internal and external appeals processes “that are clearly defined, impartial, and designed to ensure that, when health care is needed and covered, consumers get it.”
“In implementing this law, we have worked to end the worst insurance company abuses, preserve existing options and slow premium increases,” an administration official said. “Through it all, protecting consumers has been — and remains — our top priority.”
The rules, originally scheduled to go into effect July 1, 2011, were actually written by the National Association of Insurance Commissioners (NAIC), which was tasked by Congress to develop several important regulations required by the law. If the law is implemented as the NAIC recommends, patients will be able to get an external appeal of a broad range of coverage denials, including denials that result from an insurer’s decision to rescind, or cancel, a patient’s policy — not just denials made on the basis of “medical necessity” as determined by the insurer.
The NAIC’s standards also say that insurers must provide consumers with clear information about their rights to both internal and external appeals, and that the companies must expedite the appeals process in urgent or emergency situations.
Well, surprise, insurers don’t like being told what to do by regulators. So they’re pushing back hard. Consumer advocates who have been in meetings at the White House in recent weeks say they believe the administration is bending over backward to accommodate the insurers.
At this rate, the country will end up back at square one, with a quarter of the population or much more uninsured, and a government on the verge of bankruptcy. It’s time for us to face facts. Health care is not a market commodity and should not be treated as such. It is a human right. For-profit entities must be kept out. Let’s scrap this fiasco of a “reform” law and implement the only plan that will work: expanding Medicare to everyone.