Repeal Obamacare? Then what?

Published August 22, 2013

By Tom Campbell

by Tom Campbell, executive producer and moderator of NC SPIN, August 22,2013

Even its most ardent supporters agree The Affordable Care Act (Obamacare) is flawed, so there is no surprise there is a growing movement to repeal this act most believe won’t cure our healthcare ills and doesn’t contain costs.

But here’s the question: If we repeal Obamacare, then what? A lot of the opposition is political posturing against President Obama but we’ve yet to hear any of those urging repeal come up with a workable alternative plan that can pass Congress. The repeal of Obamacare without something better presents an even bigger crisis to our nation’s number one problem, healthcare.

Left unchanged our current healthcare system will bankrupt this county. It is unsustainable and more of a threat to our future than the national debt or budget deficit.

America spends more than 17 percent of our gross domestic product on healthcare, a number certain to escalate as Baby Boomers get older, less healthy and need more healthcare. We spend more than twice as much per capita on healthcare than any nation in the world and 75 percent of our spending is to treat chronic diseases, many of which can be prevented. The cost for health insurance coverage for a family of four now exceeds $15,700 per year, a primary reason many employers are opting out of providing health insurance to employees and many individuals, especially healthier young people, choose not to be covered. The cost of providing health insurance benefits to employees does far more to depress corporate profits than taxes.

Most still believe we have the best healthcare in the world. We are the best for specialized medicine like invasive procedures, heart, organ and joint transplants and replacements, cancer treatment and other state-of-the art medicine. But our primary care outcomes are not nearly so good as in many countries. We rank 43rd in infant mortality, 47th in life expectancy and rank in the middle in overall health outcomes. North Carolina ranks in the bottom third of states for health outcomes.

Many say getting government out of healthcare would encourage competition and lower healthcare costs, but there’s little evidence it is or ever will happen. Hospitals, insurance companies, pharmaceutical companies and trial lawyers pay lip service to reforming the system but there are too many dollars involved and nobody is willing to accept fewer of them, so costs get higher and higher with costs shifted to taxpayers and those who have health insurance. Doctors, especially primary care physicians are pretty much prisoners to the system.

When President Lyndon Johnson convinced Congress in the mid-1960’s to begin Medicare for seniors and Medicaid for the poor we guaranteed government involvement and ever-increasing amounts of public budgets. North Carolina spends 22 percent of our budget on Medicaid, with lawmakers constantly forking over hundreds of millions of extra dollars in cost overruns each year. Eliminating or drastically reducing Medicare and Medicaid would result in revolts and riots that would make recent events in Egypt and Greece look like Sunday picnics.

So here we are. A flawed and misnamed “Affordable Care Act,” an unsustainable and seemingly unfixable healthcare system and constantly escalating costs for Medicare, Medicaid and health insurance. We are no fans of Obamacare but before we throw it out we must have a plausible and more affordable alternative. What’s yours?

August 22, 2013 at 7:04 am
Richard Bunce says:

Eliminate the employer tax deduction for employee healthcare premiums. Change the individual tax deduction for healthcare to a refundable tax credit. No mandate, just no reason financial reason not to have a basic catastrophic policy. End all Federal and State restrictions on procedures, treatments, providers so that any willing patient and any willing provider can have any mutually agreed to treatment for a mutually agreed to price. End all State and Federal restrictions on healthcare insurance. End all Federal and State single payer systems, use private insurance vouchers if the government must assist anyone with healthcare finances. It is freedom of choice and a free market that will end this cycle.

August 22, 2013 at 7:11 am
jack dawsey says:

Tom, with respect to your article on Obama Care, here are my observations: (1) The Republicans have zero alternatives, not even as much as offering up an "amendment" to improve the current, Legal Law of the Land. (2) Instead, the Republicans have turned themselves into, as Spiro Agnew would say if he were alive, "They are a bunch of negative-nabobs...or as my first grade teacher would say bout Chicken Little, "The sky is falling..." (3) Finally, let me say this: As a former Republican, 1964-2002,(obviously not my first rodeo), and as a person suffering with cancer, with medical bills presently exceeding $1.2 M, I agree with your final question. "before we throw out Obama Care, we must have a plausible and more affordable alternative." The problem with your question (that I concur with) is,"The Republicans refuse to offer up anything plausible because Republican Corporate are "in bed" with Medical Corporate.

August 22, 2013 at 7:24 am
Denise Watkins says:

I believe Dr. Ben Carson has mentioned that he has a plan in the wings when The Affordable Healthcare Act fails. He is a proponent of a Health Savings Account and personal management of one's health care. Let's hear from Dr. Carson.

August 22, 2013 at 4:31 pm
dj anderson says:

" Eliminating or drastically reducing Medicare and Medicaid would result in revolts and riots" -- blog

If the USA can't afford Obamacare, can't afford to make it work, then the above prediction would only be closer to coming true as more promises made would become more promises broken. Therefore, stopping a misstep before it is taken would make sense.

Saying, "Let's avoid looking at the problem being created by asking for a working solution first" doesn't really hold as an argument.

Is the argument now, for ACA, after second thoughts arise, really to proceed and wait for a solution to an even bigger problem?

Good rule of thumb is to not make promises that can't be kept, or afforded, and not to raise hopes falsely. There's something in people that makes them stubbornly cling on to a notion even when it becomes apparent something is amiss. People had rather put off consequences and be wrong later, not in the present.

If you think ACA is not going to work, do something right now. If you can't face any facts contrary to the truth, at least face that fact.

Big promises have been made, trying to do something good. Many a bad ending has come from just such a beginning.

We must do today what is right today. Knowing that is all we need to know.

September 12, 2013 at 8:51 pm
Jack Miller says:

It has been common knowledge for decades, even centuries, that a health diet is the key to good health. Yes, an average of 30 to 40 minutes per day of exercise helps, but low cost health care is very available at your local grocery store. Our current "system" is atrocious, but, instead of trying to fix it, we increase its size by more than 1,000 percent? What is needed next is a good dose of common sense.