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September 24, 2013

MARCUS: Healthcare debate rages on

The debate over the Affordable Care Act (ACA, known as Obamacare) seems to be a vast waste of time and energy. The act passed Congress, has been upheld by the Supreme Court, and has already done considerable good for millions of Americans.

ACA gets rid of some of the worst existing practices. Under the act, persons under age 26 can be covered by their parents’ health insurance. Under the act, persons with pre-existing conditions cannot be denied insurance. Under the act, all persons are required to carry health insurance.

Yet the argument goes on because the proponents of the act have failed to explain how it works, what it will cost, who will be affected in what fashion. That leaves openings for opponents of President Obama to attack under the cover of ignorance by the public.

Clearly the act is imperfect. It was passed by Congress which is the greatest sausage making machine in human history. It has many ambiguities that have not been resolved or even clearly identified.

If there is one underlying problem, it is the act fails to sever the tie between health insurance and health care. The idea that Medicare could be extended to all citizens runs contrary to the interests of the insurance companies that now reap great financial benefits.

None of this will lower the costs or the price of health care. It will, however, increase access to health care, which is a reasonable national goal. To lower the price of health care, one must change the way health care is provided and the accounting system behind health care pricing. Today, price does not necessarily reflect costs.

Gov. Mike Pence has been quoted as saying that no one is denied health care because he/she can always go to the emergency room. Yet, we all know that the ER is the most expensive entry point to the health care system. That is because hospitals price the expensive equipment and services of an ER into any event that takes place in an ER. If hospitals maintained clinics for non-emergency events, the prices would be lower for those events.

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