8.9.15
Dear Pete,
I read your reply letter to Cherry about the ACA and Congress and am glad that you and your staff are complying.
Several of your statements made me curious and I’d like to comment on them briefly as I know you and your staff are busy.
This was the first statement that caught my eye
“I strongly believe that my staff should have the right to express their conscionable objections to ObamaCare, a program whose premiums help fund other plans that cover abortions and contraceptives.”
My understanding is that the Hyde Amendment prohibits federal funds from being used for abortion except in very specific instances – incest, rape, and threat to mother’s health. This is federal law.
According to the Kaiser Family Foundation:
“In states that do not bar coverage of abortions on plans available through the Marketplace, insurers may offer a plan that covers abortions beyond the federal limitations, but this coverage must be paid for using private, not federal, dollars.”
So it is unclear to me how Obamacare premiums can be used for abortion. And surely you are not against family planning and contraception?
My second concern is your Party’s knee jerk rejection of the ASA or Obamacare.
Healthcare spending is out of control. The results we get in America from that spending puts us in the middle of the pack of nations in terms of health outcome –our bang for the buck, if you will. The ACA is an attempt to remedy that by increasing coverage while making our use of resources more accountable. It is not perfect but it is a start and there are some good things in it. More people are covered. There is no lifetime limit on benefits, so that someone with a truly catastrophic illness is not denied coverage after a time. People that heretofore could not get insurance because of a pre-existing condition can now get coverage. Our daughter could stay on our insurance until age 26 after college. These are good things.
The administrative burden is onerous to be sure. You can split the economic assessment along Party lines.
Atul Gawande M. D. has a good suggestion that won’t fly in present day DC but should. Take the parts of the ACA that work and keep them AND work together to modify and improve those that don’t.
I realize that requires thinking and dialogue. It is much easier to say,
“I will do everything in my power to ensure this disastrous law is dismantled.”
And as far as “a true and free market driven healthcare system” is concerned, I think of Matthew 6:24.
“No one can serve two masters; for either he will hate the one and love the other, or he will be devoted to one and despise the other. You cannot serve God and wealth.”
We benefit greatly from our free market, capitalist system. If I want to buy a shirt or a car I shop and determine the best choice for me.
Healthcare is different. As a consumer or patient I don’t make the choice of what treatment I will get. My doctor does. Surely all the free market advertising we see can direct me where I go for care – adding untold amounts of cost to that care – but what I consume is out of my hands. So a free market healthcare system is really an oxymoron.
Either we are dedicated to delivering the most efficient high quality care to the most people or we are dedicated to our healthcare systems’ making money. We cannot serve two masters – profits or people that is our choice. Our free market system now maximizes wealth. The ACA is an inchoate imperfect attempt to remedy that. And on that front it will fail.
Our country and our politics are now ruled by money. Wealth rules. So be it, but let’s at least be honest. That is our nation’s priority. I have heard nothing from either Party that makes me think otherwise.
Meanwhile
“I am working tirelessly with my colleagues to develop common-sense reforms that reduce costs while providing Americans access to the quality care of their choice.”
What does this mean? You and your party have had years to address this problem and I have seen no specifics. Why? I know why. Because the problem of healthcare is difficult and some would even say unsolvable. I guarantee if I gave you a magic wand and said fix healthcare, you, just like all the rest of us, could not do it. It is difficult! And platitudes and slogans do not help.
Dialogue, compromise, talk to each other, think of your constituents not the Allen Stanfords of the world. We count on you to lead. Lead! Quit harping.
Yours truly,
David Haymes M.D.
Other Things 
Very well said David. I totally agree very few of us Docs have the courage to speak up for what is right and I strongly applaud your courage and strong conviction.
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Here, here!!
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Well put David. Agree entirely.
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Spot on! They keep saying that the ACA is bad, but they never say how they would correct it. I hope he reads your resoonse.
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Excellent response, Dr. Haymes. When Americans are polled about the individual elements of Obamacare, they favor them. But still a slim majority say they oppose Obamacare overall. This is irrational, of course, and is due mainly, I suggest, to the continual stream of misinformation unceasingly spewed by congressmen like Sen. Sessions. Solution: the ballot box. Vote for candidates who favor health over profits.
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Thanks LD. Sorry we’ll miss you guys in SF. Enjoy your trip.
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Well said.
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You go, David! An extremely well-researched, intelligent commentary, as always.
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Amen, preach on brother– thank you David. I have wanted to comment on this subject, but could not have done so nearly as effectively as you have. ACA had to be passed when it was as it was or there may not have been a chance to do so again. I am sure the Congressmen who got it done knew and expected it to be modified and improved, hopefully with collaboration, in subsequent sessions, but that they hoped to beat back the efforts of the extreme right to cancel it altogether.
Hopefully that will be the case.
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Thanks Nelson. I still haven’t forgotten your help in getting me through my internship. For that I also thank you!
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David spot on and coming from you as a doctor adds credibility to your observations and commentary. I having spent most of my career in corporate management have seen how the ever increasing health care costs have been such a burden on budgets. Then there is the give away to insurance companies and drug companies with the meds coverage for us seniors. How can any congressman support the prevention of Social Security asking the drug companies to bid on what they charge the government for our meds yet major insurance companies can. Shows how the system is rigged.
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