It’s better to mend it

I have heard and read a great deal about “individual choice” to buy health insurance being restored by the GOP proposal to repeal and replace the Affordable Care Act, including in this newspaper’s editorial on Thursday. However, I have not heard a peep about the other side of this coin—the Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals that accept Medicare or Medicaid payments to treat patients without reimbursement.

Those unreimbursed costs are shared by paying patients in the form of higher charges and higher insurance premiums. That is an unfair and economically unsound method of distributing costs, placing a greater burden on the sickest among us.

There are two options to provide a fairer cost-distribution system. First is to repeal EMTALA and let individuals that cannot pay be turned away from emergency rooms. Surely that is not the nation we have become! The other option is to make sure that everyone either has the personal means to cover any medical situation (and there are very few of us that can) or that everyone has health insurance. Short of a single-payer system supported by taxes (a nonstarter, as I recall), that leaves a mandate with incentivizing subsidies based on need and penalties to persuade everyone to purchase health insurance, which is what the Affordable Care Act provides.

I believe amending the Affordable Care Act to work better in the areas needing improvement is a far better solution than the plan proposed to replace it. JANET STEWART Little Rock