Tuesday, Jun 19, 2018
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S. Amjad Hussain


Obamacare aftermath: Romney's U-turn, flaws in the law

Some thoughts in the wake of the landmark ruling by the Supreme Court on the Patient Protection and Affordable Care Act, commonly referred to as Obamacare:

The court upheld key provisions of the law in a split decision. Chief Justice John Roberts surprised everyone by siding with the liberals on the court.

I am surprised at Mitt Romney's U-turn on his own health-care legislation when he was governor of Massachusetts. He says the Massachusetts law has no resemblance to Obamacare.

In reality, there are more similarities than differences. Both laws include an individual mandate, as well as a mandate for employers, to obtain health insurance.

In Massachusetts, small businesses with 10 or more employees are required to provide health-care coverage to their workers, Obamacare generally places the floor at 50 employees. As the cliche goes, if it walks like a duck and quacks like a duck, it can't be a chicken.

During presidential primary debates, then-Republican contenders Newt Gingrich and Rick Santorum rightly said that Obamacare was spawned by Romneycare in Massachusetts.

After the Supreme Court ruling, Mr. Romney said he would repeal the law as the first act of his presidency. Presidents cannot repeal laws; only Congress can. And repealing a law is a lengthy and messy process, which is strewn with obstacles of public opinion and procedural roadblocks.

Ours is the only country among the industrialized nations that lacks a comprehensive health-care policy. Somehow, we consider health care a privilege rather than a human right. We spend twice as much as other industrialized countries on health care per person, but have precious little to show for it.

On most health-care statistics, we fall short. And we had, until the passage of Obama-care, 50 million Americans with no health insurance.

Ten years ago, the World Health Organization ranked health care in 191 countries. Italy and France were rated at the top. The United States was 37th. We were 33rd in death rates for children under the age of 5. On immunization, we ranked below some sub-Saharan countries.

A few years ago, a report by the prestigious Commonwealth Fund compared indices such as access to medical care, health coverage, status of national health, quality of life, and fairness of the system to citizens. We trailed other industrialized countries on all indices except one: We excelled in emergency and acute care.

I often hear about the need for individual responsibility from my affluent and mostly Republican friends. Somehow, they think everyone with ambition can prosper.

They seem to say: "Look at us. We made it through hard work and hardship, so everyone else can make it." The reality of life is somewhat different when one takes off the conservative rose-colored glasses.

Marie Antoinette's famous quotation, perhaps wrongly attributed to her, permeates the thinking of my friends on the right of the political spectrum. She is reported to have said that if peasants didn't have bread, they should eat cake.

The Affordable Care Act is not perfect. It was considerably watered down because of compromises and capitulations by President Obama. But in the past two years it has been on the books, it has affected many Americans in the most positive ways.

As my colleague David Kushma, editor of The Blade, noted in his comprehensive column a week ago, more than 97,000 young adults in Ohio have health insurance under the provision of the law that enables those under 26 to be covered by their parents' health insurance.

Last year, more than 2 million Ohioans received free preventive services such as mammograms, colonoscopies, and wellness visits with their doctors, without deductible or co-payments. And the law has helped Medicare recipients avoid falling into the so-called doughnut hole, where all of a sudden coverage is reduced and out-of-pocket expenses soar.

Extrapolate these numbers to the entire country, and it is not hard to realize that Obamacare is making a difference in the lives of many Americans.

Obamacare still leaves about 20 million people uncovered. Though I would have preferred single-payer universal health coverage, I accept a flawed law that helps the poor, the elderly, and those unfortunate Americans who have fallen on hard times through no fault of their own, over the greed-driven system that we have put up with for far too long.

Dr. S. Amjad Hussain is a retired Toledo surgeon whose column appears every other week in The Blade.

Contact him at: aghaji@bex.net

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