To the Editor:

A lifelong career in health care — including work as a catastrophic case manager for a hospital and later for one of the largest health insurers in the US — gives me a unique perspective on the many good aspects of the ACA, Obamacare. A look at healthcare delivery from the ’60s to the present provides insight into the challenges facing the industry. Who gets healthcare and who dies as a result of the failures in this process are critical questions for every one of you.

Efforts to improve affordability of healthcare reach back to the ’70s at a time when many businesses provided healthcare policies to their employees at no or slight employee costs. Copays and deductibles were pretty much unheard of. Medicaid and Medicare did exist, along with other programs to ensure affordable healthcare for seniors and those with lower incomes.

As healthcare costs rose due to technology and profit-takers, managed care plans developed and grew by increasing numbers. Managed care plans, Health Management Organizations, indemnity plans, point-of-service plans and preferred provider organizations developed. Medical providers were no longer in control of the delivery of healthcare. Employer bargaining heated up with insurers to limit costs that passed on to employees as higher premiums, copays and deductibles.

Millions of Americans were receiving late entry into health care for manageable chronic and preventable acute health problems as coverage was lost. People began to lose their homes and savings to expensive health care costs. I personally case managed many of these individuals, and many did not survive.

Politicians are backed by insurers/lobbyists to control how laws could be made and implemented. Large insurers receive unimaginable profits that go to CEOs and investors.

Obamacare was modeled after Mitt Romney’s Massachusetts health care plan (Romneycare). Despite Republican resistance, the Affordable Care Act passed on March 23, 2010.

In North Carolina, previous governor McCrory refused to expand Medicaid. This creates further health care crisis, especially in eastern North Carolina. Doctors have formed limited groups of care to help the people who earn too much for Medicaid limits and too little to afford a policy. When the mandate for coverage ends this year and younger adults are not required to buy insurance, premiums will rise as a result. Pre-existing coverage is now endangered.

The Trump administration found crafty ways to destroy the ACA. The Republican supermajority still controls our state and vetoes so many of Governor Cooper’s initiatives on all levels. Also, the State Health Care plan was passed Monday, Oct. 22, to reduce payments to providers in North Carolina to Medicare levels of reimbursement. Providers in many cases will be unable to survive the increased operational costs.

Democrats have fought for you and will continue to do so.

 

Elaine Wood, RN, BSN

Washington