Recently, President Obama's healthcare law has been met with more challenges and "delays" than when it was rapidly pushed through Congress during his first term.
Many critics of the legislation argued that the rush to produce a product (predictably in time for the re-election campaign) would result in poorly thought out, overly-complex law that would be nearly impossible to understand and implement.
Four years ago, there was insufficient infrastructure at both the Federal and State levels to roll out such a piece of legislation–not surprisingly, things are no different today. Rather than focusing on preparing for the implementation of sweeping reform, court battles have been fought, billions of tax dollars spent and complex decisions have been rendered by the Supreme Court.
Now, we are beginning to see that many of these critic's concerns were in fact quite valid. A few weeks ago, it was announced that the Obama administration would "delay" until 2015 the mandate that business provide healthcare insurance or pay a fine. As I recall, this was one of the cornerstones of the healthcare law–statements from the White House indicate that it was "delayed" because there was insufficient infrastructure to provide more than one choice of insurance in the October premier of the Healthcare marketplace–the law promised multiple choices for small businesses. (surprised? C'mon, not really)
Today, the New York Times reported that yet another provision in the healthcare law is going to be "delayed" due to the fact that those that must comply need "more time". Interestingly, this provision was another one of Obama's cornerstone promises–there will be limits set for individual out of pocket expenses. Today, buried deep within other unrelated legislation, it was discovered that this particular consumer protection provision has been "delayed" until 2015 due to the fact that the poor, over-burdened insurance companies need "more time" to work on readying their computer systems to handle these particular co-pay limits. (yea, right). In my experience, insurance companies seem to be able to deny claims and disapprove treatments, drugs and procedures for my patients at an alarmingly quick pace. It's all a matter of priorities I guess.
What's my take on all of this? It's the patient (or potential patient) that ultimately suffers….
The government and the healthcare law is playing favorites. The law was supposedly passed in order to protect the individual American from escalating healthcare costs. The law was created to provide affordable, sustainable healthcare to every American citizen. The law was created in order to ensure quality care and contain costs. All of these goals are extremely important and certainly worthy of our nation's leaders time, resources and focus. However, as is often the case in politics, much of this law is about partisan politics, re-election aspirations, campaign support and legacy. Forgotten in the midst of all of the debate is the patient. The patient is the reason healthcare exists in the first place. The patient is the reason most physicians and other healthcare providers go to work early each day. In the latest "delay" in the healthcare law, consumers (and hence, the patient) will now have no protection from insurance company charges and co-pays. By allowing the out of pocket limits to go unenforced, the Obama administration and Congress are effectively providing the insurance companies with a license to charge as much as they can–make as much profit as they can–until the legislated limits are actually enforced. Many potential patients may not seek care because of the burden of cost. Many of these patients will suffer with devastating but curable disease. Many will die.
That's capitalism right? But should it be allowed to function at the expense of human lives?
For too long, the debate over healthcare costs and reform has centered around physicians, physician payments and hospital costs. Isn't it time we considered holding insurers responsible for years of abuse?–charges to consumers for insurance are far in excess to claims paid. Most insurance companies that I deal with on behalf of my patients have lots of people trained to "deny" requested medically indicated treatments and procedures. It is time for government to step up and advocate for the patient. We must hold all players accountable for healthcare reform–physicians, hospitals, lawyers as well as insurers. Lets stop playing favorites. Lets focus on the patient. Primum non nocere should apply to government, insurance companies, lawyers as well as physicians. Primum non nocere…Primum non nocere…