Debunking Obamacare Objections

As I read it, there are three main reasons why so many Americans object to what’s been epony-mously called Obamacare.

No. 1 is the objection to government telling us we must have health insurance if we don’t want any.

That’s pretty ridiculous to me. It’s like saying we can’t have government telling us we have to school our children. And if we use that comparison, it’s why the Supreme Court should have upheld the mandate under the welfare clause of the Constitution.

No. 2 is that it would give medical panels more leverage in deciding when certain tests or procedures are not warranted because government might not subsidize knee replacements for a 100-year-old patient.

“…I’m a big Kaiser Permanente fan and a believer that something similar also would be the logical candidate for a single-payer system – if we ever get that far.”

Opponents like to call these “death panels.” I call them death-of-silly-procedures panels.

No. 3 is cost. It will cost more in the short haul; maybe less over time, but that’s not assured unless we can tamp down or even halt the spiraling cost of the care itself.

That last objection can be overcome, but not the way we run medical care today. There are too many systems, too much duplication, not enough nonprofit hospitals, clinics or doctor offices.

But mainly it’s the insis tence of so many people on going to this doctor’s office for one thing, another doctor for another thing. Each doctor needs to do a series of tests to avoid malpractice claims. One doctor has likely never talked to the other doctor about you.

That’s why I’m a big Kaiser Permanente fan and a believer that something similar also would be the logical candidate for a single-payer system – if we ever get that far.

But there’s urban myth. “Kaiser’s really bad, isn’t it?” a friend asked me. “You have to take whatever doctor they give you and wait forever.”


Maybe 50 years ago.

Certainly not today. You pick your doctor and you almost always can see him or her on the day you want.

When any Kaiser doctor pulls up your file on the exam room computer, there’s your entire medical history.

Need a blood lipid test? Nope, you had that recently. But you’re overdue for a colon exam.

Mainly, Kaiser is proactive, where your plethora of individual doctor offices may not be. Kaiser does all your meds online. It sends you health reminders. It’s trying to get out ahead of you being sick.

That saves money. Kaiser calls me and emails me. I can’t escape preventive appointments or an eye exam even when I’m inclined to put it off.

If everyone were in such a proactive system in Obamacare, we’d have those money savings. Your internist would be talking to you heart doctor and your bones doctor.

The government won’t demand that you join Kaiser, but it should demand that insurance be tilted toward similar hospitals, clinics or health care organizations such as Southcentral Foundation in Alaska or CareOregon in Portland. Or Kaiser.

Finally, the issue about insuring the uninsured is really the rest of us protecting ourselves. Under the current system, the uninsured use hospital emergency rooms. They cannot by law be turned away. That drives up hospital cost.

If you’re simply a states-righter or a go-away-government Tea Party fanatic, my arguments won’t move you.

But maybe tomorrow’s insurance rates will.