Wednesday, March 22, 2017

Wisdom Wednesday: ACA Repeal-Replace Bill Troubles Medical, Nursing Groups

Major medical societies such as the American Medical Association (AMA) worry that a House bill to repeal and replace the Affordable Care Act (ACA) will translate into fewer people with health coverage and the care they need.

They say that the bill’s new tax credits for buying and private plan are less generous than those under the ACA, particularity for low-income Americans, a claim supported by a recent Kaiser Family Foundation analysis. They are also troubled by major changes to Medicaid – namely, a per-capita cap on the federal contribution to state programs, which could leave them underfunded, and a rollback of expanded eligibility in 31 states and the extra federal dollars that come with it.

“While we agree that there are problems with the ACA that must be addressed, we cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations,” ACA CEO James Madara, MD, wrote members of Congress yesterday.

Speaking for the American Nurses Association, President Pamela F Cipriano, PhD, RN, FAAN, joined the dissent. “In its current form, the bill changes Medicaid to a per capita cap funding model, eliminates the Prevention and Public Health Fund, restricts millions of women from access to critical health services, and repeals income based subsidies that millions of people rely on. These changes in no way will improve care for the American People,” she said in a prepared statement.

Other medical societies expressing similar criticisms and reservations include the American College of Physicians (ACP), the American Academy of Family Physicians (AAFP), the American Congress of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the American Osteopathic Association.

The concerns about the AHCA extend to other quarters of the healthcare industry. Rick Pollack, president and CEO of the American Hospital Association, also wrote members of Congress that this group could not support the measure as drafted. And Georges Benjamin, MD, executive director of the American Public Health Association (APHA), said in a news release that the bill “would jeopardize the health and lives of millions of Americans.”

My Take:
The Affordable Health Care Act certainly has its’ problems. Mostly, because it is not a single-payer system. Now that everyone has agreed that providing health care is a very complex issue maybe we can modify what we have rather than start over.

Regardless of any health care plan, the treatment of chronic illness will bankrupt this nation in my lifetime. As of 2012, about half of all adults – 117 million people – had one or more chronic health conditions. One in four adults had two or more chronic health conditions.
Obesity is a serious health concern. During 2009-2010, more than one-third of adults, or about 78 million people, were obese. Nearly one of five youths aged 2-19 was obese. And these number continue to rise.

Diabetes is the leading cause of kidney failure, lower-limb amputations other than those caused by injury, and new cases of blindness among adults. The total estimated annual cost of this preventable disease was 245 billion dollars in 2012.

The Bottom Line:
Until we develop a health care system based on prevention rather than crisis intervention and disease maintenance, the costs will continue to skyrocket.

Source: March 8, 2017 Medscape

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