One of my colleagues wrote a letter stating his opposition to The Affordable Care Act (ACA). Since I support the provisions of the ACA, or “Obamacare,” I am writing to explain why. Most primary care doctors support the ACA. The American Medical Association, American College of Physicians, American Academy of Family Physicians and American Academy of Pediatrics all supported the passage of health care reform and continue their support. This law will provide health insurance access to 95 percent of all legal U.S. residents, where before over 50 million Americans lacked coverage. Before ACA, 25 percent of our fellow Americans had no or inadequate health insurance and little access to primary care and preventive health services like immunizations, mammograms and colon cancer screenings.
The ACA is already working. It provides protection from adverse business practices of insurance companies, like eliminating lifetime caps on benefits, prohibiting cancellation of insurance when an expensive illness occurs and eliminating restriction for “pre-existing conditions.” At least 80 percent of the insurance premium must be spent for benefits. The Medicare Part D “donut hole” will be gradually closed. Young people can now have coverage on their parents’ plan to age 26.
The ACA provides funds to train primary care doctors, physician assistants, nurse practitioners and other health professionals. It increases both Medicare and Medicaid payments for primary care visits and services. There is increased funding for community health centers. Health care quality improvement is supported.
The charge that $700 billion is being “cut” from Medicare is misleading. This figure includes stopping windfall payments to insurance companies now provided for Medicare Advantage plans that, in my experience, do not compare favorably with traditional Medicare and should be eliminated. It also includes reductions to hospitals formerly intended to offset the cost of caring for uninsured patients who will now be covered under the ACA by Medicaid.
These are a few reasons why so many doctors and their professional organizations support Obamacare. After 100 years and many tries, President Obama has delivered near-universal coverage with incentives to improve access and quality of care. Of course, improvements will be needed just like our other great social experiments, Social Security and Medicare. I think part of the resistance we hear is explained by the Law of Reform, written by Nicolo Machiavelli in 1513: “The reformer has enemies in all those who profit from the old order and only lukewarm defenders in those who would profit from the new order.”
As a doctor, I see Obamacare as a great step forward.
Peter J. Reiter, MD, FACP