Who Should Lead on The Path to ‘Utopia’ in American Healthcare?

Originally published in Bucks County Courier Times

The New York Times reports that there is unity of thought in certain circles about how the reach of the Affordable Care Act (ACA, aka “Obamacare”) should be expanded.

That’s unsurprising. Parasitic, special interests will tend to think alike when it comes to sucking nutrition from a host.

The profiteers of Obamacare — for example, gigantic health insurance companies and increasingly monopolistic, regional, health systems — never lose sight of their objective of increasing profits or of the need to bend lawmakers in a direction that serves that objective.

When it comes to understanding this perverse feature of America’s healthcare economy, the public is decidedly not “woke.”

The complexity of “the system” deters most people from even thinking about where all the money is going.

Consider:

1.) The very design of the ACA, misnamed because of its emphasis on coverage — not affordability and not care — has produced a windfall for the alpha parasite among the special interests, the insurers represented by AHIP (America’s Health Insurance Plans), a lobbying organization known for the generous donation of its “influence” among politicians on both sides of the aisle.

2.) Also enjoying big increases in profit after implementation of the ACA were certain hospitals. Curiously enough, hospitals categorized as “non-profit” did quite well, sometimes at the expense of the indigent patients they claim to serve. By the way, the AHA (the American Hospital Association), is another of Washington’s heavyweight lobbyists.

Note to dozing America: there are CEOs among the nation’s top “non-profit” hospitals whose annual income is close to $20 million.

Feeling “woke” yet?

Most Americans view hospitals and the physicians who staff them as a single entity. Yet in recent years, there is a growing divide between the “suits” and the “scrubs,” the executive-administrative class on one hand and those who actually practice medicine on the other. With slightly more than half of America’s physicians now being hospital employees, few speak out against what they’re seeing and the direction in which things are headed. Hospitals like it that way; each year, they net an average of $2.4 million for each doctor they employ.

The AMA (American Medical Association) long ago ceased representing practicing physicians. Less than 15% of them are members, and the dues collected in 2018 were 10% of the AMA’s $332 million in revenue. By developing other revenue streams, the AMA has made common cause with the parasitic coalition to survive.

Yes, everyone agrees with the platitude cited by the New York Times in its report: “Americans deserve a stable health care market that provides access to high-quality care and affordable coverage for all.”

But the ACA did nothing toward that end, nothing to reduce costs or the forces that drive them upward, a fact that is nothing if not monumentally awkward.

Will “expanding the ACA” change that?

Of course not.

Over the decades, our legislators have woven together legislation that relentlessly favors members of the parasitic coalition. The result? Consumers pay more for less time with a physician, assuming that they can meet with one.

The profiteering special interests that dominate the warped economy of heath care in America are already leaning on the new administration in Washington. Most people want transparency in the pricing of services. The entrenched special interests oppose it. It’s their “jam.”

The same interests pursue consolidation in the direction of near-monopoly power. We shall see how well the new Secretary of Health and Human Services, Xavier Beccera, lives up to his reputation by resisting their efforts and reversing damage that has already been done.

Perhaps Congress can reverse its headlong plunge to the bottom in public opinion polls by listening to different voices — physicians who actually care for patients. Absent a change of “influence,” Congress will reverse that plunge to the bottom when pigs sprout wings.

America, who do you trust to make the ground rules for a better system of health care — a system defined by (1) easy access to medical care at (2) reasonable cost, and (3) relationships between physicians and patients that are unburdened by the sapping effects of an entire class of parasite?

Do you trust the business interests, like the million-dollar CEOs of the parasitic coalition?

Do you trust the politicians who look to the parasitic coalition for the funding to keep their jobs?

Or would you consider hearing what a grassroots movement of fed-up physicians, people who swore an oath to protect you, has to say?

Forget “Utopia.” Simple sanity will do.

Marion Mass, M.D. is the co-founder of Practicing Physicians of America. She serves on the board of the Bucks County Health Improvement Partnership, the Bucks County Courier Times, Doylestown Intel, Editorial Board. She has been a Pennsylvania Medical Society delegate and is an AMAC member who has spoken about the cost of health care at AMAC Action’s Delegate Conference.