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Uncertainty Still Clouds Health Care Law


The New York Times summarizes quite accurately the current status of the Affordable Care Act.

Three years after President Obama signed the health care reform law, there are concerns that the process of implementing it will be rocky. Even some of the law’s supporters are worried.

Perhaps more troubling for the White House, the Affordable Care Act is still not well liked or well understood. The Obama administration had hoped that over time, the legislation would gain enough support to help smooth over the rough patches of putting it into practice. Instead, public opinion has remained mostly static: a plurality of Americans still disapprove of the law, and a substantial portion of the public remains uncertain about what it says, according to recent polls.

Now the National Physician’s Alliance has published and emailed a position paper endorsing the ACA as the greatest good for the public health, without addressing basic concerns expressed by those who oppose the ACA as it is now mandated.

Their own analysis reveals the dichotomy of approval and disapproval of specific portions of the ACA, and disregards the critical financial aspects of implementing the far reaching mandate that will reach into every sector  of our lives and the economy.

There is even confusion about whether the health care law is still, in fact, law. A Kaiser Family Foundation survey [PDF] conducted in April found that 41 percent of American adults did not know that the Affordable Care Act remains the law of the land. A separate tracking survey conducted by Kaiser, which has done far more surveys on health care than any other polling organization, found that roughly half of American adults said they did not have enough information about the law to understand how it will affect them.


The National Physicians Alliance disregards several key and critical elements:

1. The use of the IRS to monitor businesses who provide, and individuals who have health insurance.

2.The misguided intent to expand Medi-caid to accept the uninsured.  It is a means tested subsidy

3.The effects upon business growth and increasing business operating expenses.

4.The largely untested rate of implementation and the integrated use of health information technology and federal incentives and subsidies for HIT

5.The effects of meaningful use, forcing MDs to accept inadequate electronic medical records systems which reduce clinical efficiency.

6.The lack of accessibility to primary care physicians in many regions of the country. This will take at least five to eight years to address unless unqualified

Even the National Physician’s Alliance whose work is guided by the principles for health care reform advanced by the Institute of Medicine: proposes that:

  1. Health care coverage should be universal.
  2. Health care coverage should be continuous.
  3. Health care coverage should be affordable to individuals and families.
  4. The health insurance strategy should be affordable and sustainable for society.
  5. Health insurance should enhance health and well-being by promoting access to high-quality care that is effective, efficient, safe, timely, patient-centered, and equitable.

The ACA as written cannot meet the requirements of #4.


One reason the Obama administration might still be optimistic is that while surveys have consistently found that a plurality of Americans have an overall negative view of the Affordable Care Act, they have just as consistently shown that large majorities of Americans favor individual elements of the law.

For example, Kaiser has found that about 70 percent of adults support providing financial assistance to low- and moderate-income Americans who do not have employer-provided health insurance, and also that about 70 percent support health insurance exchanges and the elimination of out-of-pocket costs for many preventive services — both elements of the health care law.

Physicians by a vast majority want a Health Law that will insure all Americans, they are a keystone for healthcare, they know what has worked and what does not, and we insist on a stable workable model financially for all components of the health system…..not a pipe dream.


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