Business values are not health values

Senate Majority Leader Mitch McConnell and lots of other GOP senators have been saying we campaigned on repealing the Affordable Care Act, it is what got us in control of both the House and Senate. We must follow through.

Well, yeah, but what you proposed has only a 17% approval rating. Doesn’t that tell you something?

This morning on NPR’s *Weekend Edition Sunday* host Lulu Garcia-Navarro talked to Elisabeth Rosenthal, editor-in-chief of Kaiser Health News. The conversation is about the high cost of healthcare in America and the GOP favorite claim that all our health costs would be just fine if we allowed for more market force competition.

* What needs to happen to maximize profits is quite different from what needs to happen to maximize health. The healthcare system is now driven by business values and not health values. The best way to increase revenue is to see eight patients an hour and order a lot of tests. The best way to increase health is to sit and talk to the patient and understand the illness and any issues that might get in the way of healing.

* Drug companies, now run by business people instead of doctors, jack up prices on drugs to see if they make more money. They do this because Medicaid and Medicare are prevented from negotiating prices. That’s something done by all other countries with a national health system.

* The price of a test or operation is completely hidden until the patient gets the bill. The quality of a provider is also rarely available. Labs don’t advertise prices, though what they charge could vary by a large amount. One lab might charge $7 for a test, another might charge $700. This matters as deductibles and copays increase. A patient can’t make a market based decision without at least price.

Sher Watts Spooner, writing for DailyKos, says there is a slight chance the GOP will reach out to Dems and start talking about “repair” instead of “replace.” Yes, there is lots on the ACA to repair. And lots of lists of things on what should be repaired. These things might include (depending on which list you read):

* Changing the payment system away from fee-for-service and towards accountable care organizations.

* Public reporting of quality and price data.

* Increased subsidies.

In the list is, of course, a single payer system. Though the current GOP won’t touch it, Warren Buffet now calls the current Senate bill, “Relief for the Rich Act,” and he now supports the single-payer system (though we’ll see if he backs that support with any cash to sway lawmaker opinion).

One reason to go for the single payer system is so that employers no longer have to deal with it. Employers, especially smaller ones, don’t like the ACA because of the burden placed on them. A single payer system would also provide healthcare to those who don’t have jobs – which, for reasons of ranking, is why the GOP won’t touch it. In their opinion if you don’t have a job you’re not good enough for them to spend money on you to keep you well.

Spooner notes that if Dems help improve the ACA the GOP will get all the credit. The Dems are willing to not get the win if their constituents are better off. The GOP insists on the win even if their constituents are worse off.

Jon Perr, also of DailyKos, takes a look at the source of the GOP antagonism to the ACA. Part of it is that the GOP doesn’t want gov’t to be big, to help people solve problems, to have people be dependent on gov’t. All of these reasons are based in ranking – I don’t want you educated enough and healthy enough for you to challenge my position in society.

Another part goes back to when Prez. Bill Clinton tried to pass a healthcare program. The GOP wasn’t fearful of a healthcare system that failed, but one that succeeded. America already had Social Security and Medicare. Both were brought into being by Democrats. A gov’t takeover of healthcare would make Americans so grateful they “could provide Democrats with an enduring majority for years to come.”

The battle to prevent comprehensive healthcare killed the Clinton proposal. That battle was renewed when Obama took office. It didn’t kill the bill, but severely tarnished it, enough that the GOP took over the gov’t this year. Might their attempts to repeal bring the Dems back into power in such a way they have that enduring majority for years to come? One can hope.