It was easy to fore­see cur­rent trou­bles with the ACA

Modern Healthcare - - COMMENT -

The world isn’t fair. But we can­not just wait for things to get bet­ter, as many do by fail­ing to vote at elec­tion time. We have to act, as Dr. Clau­dia Fe­gan states in her re­cent Guest Ex­pert col­umn “Amid on­go­ing drama over health­care re­form, there’s an­other so­lu­tion hid­ing in plain sight” (July 24, p. 25).

As a for­mer health­care ex­ec­u­tive, I pre­dicted ex­actly what has oc­curred un­der the Af­ford­able Care Act: pre­mium es­ca­la­tion and de­par­ture of com­pa­nies with un­prof­itable lines. This sit­u­a­tion should not be a sur­prise to any­one in the health­care field.

Given the fact that large in­sur­ance com­pa­nies have a cadre of well-paid ex­pe­ri­enced ac­tu­ar­ies, shouldn’t they also have known that sicker peo­ple would sign up for in­sur­ance and, given rel­a­tively mi­nor tax penal­ties, the healthy ones would not? What ex­actly were th­ese ex­ec­u­tives think­ing? That they would get the usual cor­po­rate wel­fare

bailout for­ever?

The in­sur­ance in­dus­try’s bet on Wash­ing­ton’s largesse did not pan out and some are tak­ing their mar­bles and go­ing home. But this leaves mil­lions of con­sumers in dire straits, with continuing tremen­dous pre­mium in­creases. Of course the GOP-led Congress and the Trump ad­min­is­tra­tion haven’t helped make the ACA any more ten­able.

When I was direc­tor of health plan­ning for the state of Ge­or­gia back in the ’70s, health­care was about 8% of the gross do­mes­tic prod­uct. Now it is more than dou­ble that; soon it will be triple. With other pri­or­i­ties fac­ing the na­tion, we sim­ply can­not af­ford to have health­care ex­penses con­tinue to grow at that rate.

War­ren Buf­fett, no so­cial­ist, was re­cently in­ter­viewed by “PBS NewsHour” (June 27). Dur­ing the dis­cus­sion, Buf­fett said that be­cause of all the above, a sin­gle-payer health­care sys­tem seems to be the only vi­able op­tion for Amer­ica.

The only way to cap ex­ces­sive health­care spend­ing is through Medi­care for

All and cen­tral­ized bud­get­ing. When you ex­am­ine ev­ery other de­vel­oped na­tion, you find that all have uni­ver­sal cov­er­age, and ev­ery last one of them does a bet­ter job of con­trol­ling health­care costs, with bet­ter out­comes.

Jack Bernard Peachtree City, Ga.

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