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The facts show that Obama-style health care is unsuccessful

April 28, 2016
Westfield Republican


I must respond to Dr. Joel Potash's letter of a few weeks ago (which was in reponse to a letter I wrote). Dr. Potash appears to be a fan of the Affordable Care Act (ACA) and eventually a single payer system. Let's take a look at the facts.

He states that 9 million Americans have enrolled in the ACA, a figure far short of falsely inflated predictions from 2009-10. Exchanges are closing at an alarming rate and deductibles and premiums are rapidly rising, some skyrocketing. Not a single family has saved the Obama promised $2,500. Insurance companies continue to drop out of the ACA and this trend will only accelerate as an unsustainable ACA runs out of taxpayer money. People with limited resources are to be fined for not enrolling. States that accepted the Medicaid expansion are all fiscally challenged and soon bankruptcies will be occurring. And millions have lost their doctors, hospitals and policies ( that millions were happy with). Only a limited number of physicians will accept Medicaid and, sadly, many are considered 'inferior doctors'. Seventy percent of ACA enrollments are for Medicaid, one of the worst forms of insurance in this country. Some ACA dollars are going to illegal immigrants and abortion-something Obama promised would not occur. And the Congressional Budget Office estimates that once the CBO is fully implemented there will still be 30-40 million uninsured-about where we were before the ACA.

How Dr. Potash can consider the ACA a success is beyond me. Facts are stubborn things. Yes, there are a few good aspects of the ACA but the long term derogatory elements make it unsustainable and unfair to Americans.

David Catron, in a recent article in The American Spectator, carefully outlines the lies and deceptions of the ACA and makes the strong argument that virtually every promise put forward by the ACA has NOT come true.

I was struck by Dr. Potash's cynical view of his fellow physicians, suggesting that primary care doctors are more dedicated and more inclined to take self or no pay patients. He's dead wrong on that! That may be his perception ( in Syracuse) but not elsewhere. I know of NO physicians ( primary care orspecialist) that don't do more than their share of indigent care. Our group ( diagnostic radiology) budgeted $150,000 a year for indigent care. I'm on the board of the Clemson Free Clinic and, along with a pool of about 10-15 doctors, work there.

And he seems to think specialists are some degree of bad for ditching primary care. The number one criteria for superior care in a health care system is the presence of a large number of specialists.

I would be more than happy to debate Dr. Potash on the quality of our health care system compared to ANY other system in the world. He can name the place and time; I'll show up. I teach a course in Clemson called: U.S. Health Care vis-a-vis International Health Care Systems: A Critical Analysis. I've spent a total of over five years on the European continent and the United Kingdom (I donated a kidney to a close friend at Coventry in the U,K. in May 2012). I was under the care of the British national health care system for three months, which is a global embarrassment of the highest order.

I've had first hand experience with systems in Hungary, Germany, France, Switzerland, Equador, Haiti ( medical mission work with Dr. Paul Farmer), Switzerland, Italy, Cambodia, Tanzania and Vietnam. I will be in Rwanda with Dr. Farmer next year. I know a good health care system when I see it and I've yet to see one remotely as good as ours, with the possible exception of Switzerland or Norway, which are still inferior to the U.S. Let's not forget that the U.S. is first in the world in: treating strokes, heart disease, high blood pressure, cancer (and cancer research), creating new treatments and cutting edge drugs, as well as "responsiveness" (respect for the patients as well as timely access). No other country is close to us in these vital areas.

Regarding the single payer system that Dr. Potash seems to long for: as they say, "sounds good, tastes bad." He surely does not understand how Canada's single payer works.

Here you go. Single payer in Canada is very popular with healthy Canadians who never have to use it. But if you're sick, look out! A 2014 study by the Fraser Institute found that wait times for medically necessary treatment in Canada have increased from 9.3 weeks in 1993 to 18.2 weeks in 2014. Wait times were especially bad if you needed hip, knee or back surgery (42.2 weeks) or neurosurgery (31.2 weeks).

Necessary heart bypass surgery in Canada takes place approximately 12-16 months LATER than it would in the U.S. under the same clinical conditions! Result: sadly, many of those patients will die before their surgery occurs!

As we know from the U.S. VA scandal, health care delayed is health care denied. The people who suffer the most under the Canadian system are those who can't pull strings to get treated in the U.S.!

There are few truly single payer systems in the developed world. Canada is one and Taiwan is another. Sweden has moved from a single payer system to one with private insurers.

Martin Samuels, MD., who founded the neurology department at Harvard's Brigham and Women's Hospital, found this out when he worked as a visiting professor in Canada. "The reason the Canadian health system works as well as it does ( and this is not by any means optimal) is because 90 percent of the population lives within driving distance of the U.S. where Canadians can be Seattled, Minneapolised, Mayoed, Detroited, Chicagoes, Clevelanded and Buffaloed."

Dr. Potash's heart, I believe, is in the right place. He has underlying good motives. Unfortunately, he comes up short on the reality and facts of the ACA. He would do well to study the real and ongoing problems with the ACA, as well as the severe problems with a single payer system.

Let's fine tune our current system, incorporating some of the desirable elements of the ACA, such as pre-existing conditions and the like.

In summary, the basic premise of "ObamaCare" was deceptive. The president and his supporters sold it as a health care reform bill meant to control costs, increase access and improve quality. But virtually none of its provisions really addressed the components of our medical delivery system that affect these things. The most important deception was the pretense that it was ever about health care. That was the big lie. Obama and his accomplices called it "health care reform" when it was really just a government power grab.

America deserved better. The last thing we need is a single payer system. That would do substantial harm to the average American, something U.S. physicians should vehemently oppose. Hippocrates would be proud.

Dr. Terence Clark,

Clemson, S.C.



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