Destroy the Patient Protection and Affordable Care Act?

by Brad Cotton

( published Circleville Herald 6 July 2012)


Governor John Kasich, Lt. Gov. Mary Taylor, Mitt Romney, Speaker John Boehner, the Republican Party are all willing to cause the deaths of thousands of Ohioans as well as oversee the physical , emotional and financial suffering of hundreds of thousands more of us. Remember that Republican primary debate just months ago when the crowd cheered for the death of a hypothetical young man without health insurance?  In the service of right wing market ideology (and in service to their megacash corporate donors) Republicans want to take from you and yours the very real protections of the Patient Protection and Affordable Care Act ( PPACA), thus leaving your family at the mercy of  the rapacious Wall Street traded health insurance industry. Ever been sick and had no health insurance? Think of standing naked outside during a hailstorm tornado with no protection. If you survive the storm, the wolves are waiting.


Thanks to last week’s Supreme Court ruling 30 million more Americans will have health insurance. 1.2 million Ohio seniors will receive cancer screening and wellness exams through Medicare. 120, 000 Ohioans, many of them children with potentially deadly pre-existing conditions will receive care. 4.5 million Ohioans will have lifetime benefit limits removed- no longer will one child with leukemia threaten a family’s financial stability, hearth and home.  97,000 Ohio children can remain on their parents insurance till age 26. No one’s health insurance can be suddenly taken away once one becomes ill because of some minor mistake on the original health insurance application. Previously, health insurers paid big salaries to unscrupulous paper pushers to review records of patients whose care began to be expensive—they always found that such profit-threatening sick patient had neglected to mention that they had menstrual cramps as a teen—Bingo! Your insurance was taken away—you died. The PPACA stops cold such “rescission of benefits”. I cheer the addition of the rescission assassins to the unemployment rolls. Too bad the PPACA will help even them avoid losing their health coverage.


The health insurers furiously fought the “80% Rule” that forces them to spend that much of your premiums on the actual delivery of patient care. Previously, some of the more slickly managed insurers spent as little as 60% of premiums delivering the care they promised. The remaining 40% went to big buildings, CEO bonuses and buying legislators. Interestingly, government that supposedly can’t do anything well spends only 3% of Medicare dollars on overhead. Already because of the “80% rule” 143,000 Ohioans will receive $11.3 million in premium rebates. Nationally, $1.1 billion will be given back to consumers because of the PPACA.


Millions of seniors, whose drug costs put them in the Medicare part “D” donut hole  will save untold huge sums of money. All of us would save a lot more if the Part “D” legislation had not been written by the pharmaceutical companies and their Republican toadies in 2003.  The statute prohibits, yes prohibits, Medicare from negotiating drug prices. Medicare must pay whatever Big Pharma asks. Former Republican Representative Billy Tauzin, the legislator responsible for the 2003 Part “D” bill was subsequently rewarded with the presidency of the Pharmaceutical Researchers and Manufacturers Association (PhRMA). Reality is always darker than you think and yes, corporations and their Republican errand boys are not on your side.

The PPACA is deeply flawed as it is after all a Republican plan based on Romney’s Massachusetts signature initiative. It amounts to government welfare for the private insurers. Politics in the US 2009-2010 was unable to accept the fact that US  market-based healthcare is not the best in the world—it is only the most expensive, and it is the most expensive because the corporate health insurers are not the answer, health insurers are the  problem. Every other civilized nation in the world has figured that out. Let’s not be so “exceptional” that we can’t learn. Cost effective and compassionate, single payer is the answer.


 Still, the PPACA at least begins to tame the beast. The interdenominational “Faithful Reform in Health Care” notes that the PPACA begins “reclaiming the moral compass of our country.” Given that 50,000 of our neighbors die every year because they had no health insurance, we have already de facto accepted conservative economist Tyler Cowen’s nightmare vision of America: “We need to accept the principle that sometimes poor people die just because they are poor.” Jesus did not accept this kind of cruelty from the moneychangers in the Temple. Neither should we. Yet we will most assuredly lose the protections of the PPACA and be once again at the mercy of the moneychangers if Mitt Romney and the Republicans win. Vote for every Democrat on every ballot this November and every election year after year. Vote for life over profits.


Brad Cotton is an emergency physician and member of Physicians for a National Health Program