Nancy Nielsen: Lose the partisan attacks and work together on health care

By By Nancy Nielsen

Enough already! We know there are health care problems in America. The cost of health care is too high, too many still go uninsured and many health outcomes could be improved. But Congress will not be able to make any aspect of health care better if you continue to demonize the opposing party or fight to keep impossible campaign promises. It’s time to put the health of American citizens first.

Growing up in Elkins, and attending West Virginia University, I was taught that we are all part of this great country and we, therefore, need to learn to work together. I was also taught basic commonsense and that it’s best to look at the facts when making a decision.

I used these lessons when I served as president of the American Medical Association at the time the Affordable Care Act was debated and, ultimately, passed. At the time, doctors were as divided as the rest of Americans about the ACA, but for those of us on the AMA board, supporting it or not was a moral issue.

Ultimately, the American Medical Association made the choice to support the bill, because the facts showed that millions of Americans would gain health care coverage, and I firmly believe that choice was on the right side of history.

Now, after the ACA’s implementation, even many doctors who firmly opposed the ACA have learned how much help has come to people in need and are looking beyond political rhetoric to the need to improve the law, instead of repeal it.

It’s time for the Senate to set aside partisanship and find real solutions to improving health care for all.

Here are facts Congress must consider now:

First, there is nothing whatsoever good about being uninsured. It shortens lives and is a huge barrier to preventive care and early diagnosis. Can’t we all agree on that? The data are insurmountable, so let’s agree to start there.

West Virginians will be hurt very badly if the Senate remains determined to repeal, rather than improve, the ACA. Medicaid will be decimated and the state will have to make up for up to half of the funds for drug and behavioral treatments. For a state so ravaged by drug abuse, this would be devastating. We must insist that Congress put people before politics.

Second, let’s stop calling any health care legislation by president’s names, whether Obamacare or Trumpcare — that deliberately galvanizes opposition to a person or a political party and contributes nothing to thoughtful analysis.

Next, while deliberations on improving access to affordable health care continue, please stabilize the insurance market with some level of predictability. Insurers hate chaos, and you are continually and quite deliberately creating chaos, causing insurers to find the risk so great that they decline to offer policies to individuals.

What kind of lawmaker chortles with glee as people in need of individual health insurance can’t find it or afford it? Put down your swords and provide a three- to five-year period of insurance predictability while you (and we) sort things out.

Then, accept what everyone knows — all have to be in the insurance pool for it to be affordable.

If “individual mandate” is too hard to swallow, rebrand it as “individual responsibility,” declare victory and move on.

Don’t try to entice people by offering bare-bones policies with diminished coverage. It sounds good, but it destabilizes the insurance market, drives costs up and leads to high deductibles and high premiums for most. Omit maternity benefits, hospitalization or prescription coverage, or mental health and substance abuse treatment, and the result is not protection, but a reckless gamble on future health care needs. Of course men may not “want” maternity benefits, but women may not “want” coverage for testicular or prostate cancer. The issue is what we all, as a group, “need” and how we are to pay for it.

Finally, approach the neediest among us with care and compassion. We are the last developed country to figure out how to configure and finance health care for all our citizens. Let’s get down to the business of doing that, and take off the table any plan that will take insurance away from people.

We are all in this together. Please start behaving that way, because lives are at stake.

Dr. Nancy Nielsen is senior associate dean for health policy in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, a past president of the American Medical Association, a member of the Institute of Medicine of the National Academy of Sciences and has served on an advisory committee for the West Virginia University School of Medicine.

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