To: Senator Cory Gardner
From: JoAnn Dolan – Colorado
Date: 01/26/2017
CC: Michael Bennet, Jared Polis, and Ed Pearlmutter (who voted against S.Con.Res.3)
Dear Senator Gardner,
I beg of you to rectify your decision on S.Con.Res.3, and help find a way to save the ACA. Let’s be
realistic- the GOP cannot provide the promised advantages of the ACA to their constituents without
some of the negatives. Insurance companies have to have a broad base of participants, young and
healthy plus sick and needy to make their numbers work; and it is precisely this requirement that
spawned the need for mandatory participation nationwide.
I challenge you to be one of America’s champions, and not placate the uninformed masses. Our
health-insurance-crisis is a symptom of a health-crisis in America, and focusing efforts addressing
chronic disease and fundamental healthcare industry and legal issues will get us a lot further as a
nation.
I believe a public relations campaign for the ACA is what is truly needed at this juncture, not repeal.
While solid information is available to those who conduct personal research, there are millions of
Americans who have been unduly influenced by half-truths and rumors about “Obamacare.” News and
social media could be used wisely/strategically to educate Americans on what the ACA affords them and
why it is detrimental to our healthcare industry, and economy, to throw the baby out with the
bathwater. First and foremost, we must STOP calling it Obamacare. It is not an insurance program, as
many misinformed American’s believe, and calling it Obamacare is a misnomer that perpetuates that
ignorance.
I humbly submit these ideas for your consideration:
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Do you truly believe a replacement plan will save us money? Wouldn’t it be better to improve
upon existing platforms, and address the fundamental reasons that healthcare costs are
skyrocketing?
Long before the ACA (since the 1980’s) Americans and their employers have been
unsuccessfully fighting the battle of rising healthcare costs- the ACA made it a glaringly Public
problem, and I hope that makes all the difference. Please do something constructive with this
opportunity.
The ACA is being blamed for the surge in insurance prices across the nation. While this appears
to be true on the surface, it is a conveniently oversimplified “alternative fact” about healthcare
costs. Long before the ACA, both employer-based and private insurance policy prices have been
increasing at dou ble digit rates (more than a decade), and that is precisely why the ACA is so
important- so that health insurance is attainable for the majority and not the minority who can
afford it. Furthermore, it has not gone unnoticed to those in the industry that the GOP (in a ploy
to derail the ACA) forced the pricing increases and caused major carriers to flee the market
when it voted to withhold $30M in funds earmarked for risk corridor payments
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(https://www.nytimes.com/2015/12/10/us/politics/marco-rubio-obamacare-affordable-careact.html). Let’s not make things worse.
The ACA is/was an answer to an already broken system, and it makes no sense to go back. Our
government should instead be focused on influencing the driving factors for skyrocketing
healthcare costs: chronic disease, fee-for-service driven healthcare platforms,
unregulated/unwieldy/confusing hospital and pharmaceutical pricing, and malpractice lawsuits.
1. Chronic disease management is complicated and requires a multipronged approach.
Efforts in addressing childhood obesity have been successful and will serve us well in
future, but for now, providing consistent and affordable preventive care for preexisting conditions helps us to avoid costlier disease management down the road
(the ACA helps with that). It will take a while to get to that next level though and we
have to stay the course and avoid knee-jerk reactions. From a NY Times article by
Robert Pear on 6/9/16: “People with pre-existing conditions are now getting treatment,”
said Antoinette Kraus, the director of a statewide consumer group, the Pennsylvania Health
Access Network, “and it’s more expensive because they were shut out of the market for
many years…” …“But, she added, “we expect that they’ll eventually become healthier, so we
won’t see these huge rate increases every year.” Kevin J. Counihan, the chief executive of
the federal insurance marketplace, acknowledged that “pent-up demand for health care is
greater than people expected and is lasting longer than expected.”
2.
We must continue conversations with insurance companies regarding fee-forservice models, which just don’t work. There is growing evidence from existing and
successful companies that results-driven payments have better patient outcomes
while curtailing costs. Perhaps the government funds a 3rd party study to influence
the industry.
3. We must somehow address pricing and unfair insurer payment practices. In all other
industries consumers are able to contrast and compare price vs quality, and
consumer demand influences prices up/down. In the healthcare industry, costs are
less transparent and consumers therefore play little part in controlling industry
pricing. Profit-driven insurance companies, healthcare providers and hospitals are
running wild with arbitrary pricing. In other industries this sort of pricing practice is
considered collusion and is illegal, and we have anticompetitive laws in place to
prevent consumer-harming monopolies; yet we have insufficient measures in place
for the healthcare industry, something that affects every single person in America at
some point in their lives. And despite industry acknowledgement of the unfair
practice, patients using in-network hospitals and facilities are still getting lambasted
with exorbitant medical bills when portions of their treatment are found
(uncontrollably) out of network after-the-fact. This is tantamount to a car
manufacturer selling cars to consumers and allowing their parts manufacturers to
collect for select parts after purchase; and you would never stand for that. Why
then does the GOP seem to take a not-my-job stance with healthcare? I’m
particularly confused since this was a Republican-supported matter until about 8
years ago, hmmmm.
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4. We must address malpractice lawsuits, perhaps by limiting awards; but more
importantly, by finding a better way to distinguish legitimate claims from frivolous
claims, and better assign responsibilities to parties involved. Not only do the direct
costs of malpractice suits affect industry costs, malpractice avoidance indirectly
costs us even more. Extensive and unnecessary tests are routinely performed in an
effort to avoid missed diagnosis and as potential lawsuit “evidence” of conscientious
and thorough care. The American Journal of Medicine produced an article on this
topic in January 2016: http://www.amjmed.com/article/S0002-9343(09)011152/fulltext
Some Americans oppose the ACA because they believe it is pushing employers away from
providing health insurance to their employees. I actually agree on that point, but I don’t see
that as a bad outcome. If we continue to tie health insurance to employers, we as a nation are
contributing to the stagnation of our free market economy. People stay with companies far past
their expiration date, rather than starting their own businesses or working for smaller
companies for fear of losing their health insurance. America needs the lifeblood of small
business and innovation, and what we’re left with right now are medium to giant companies
beholden to their shareholders, cutting back on employee health and welfare coverage levels,
reducing health insurance premium cost sharing, and presenting staggering medical deductibles
offset with the tax “blessing” of an HSA to numb the sting.
Some Americans miss their old plans because they were more affordable, and believe the higher
prices they’re paying haven’t benefited them in any way. What needs to be effectively
communicated is that the ACA protects consumers from unwittingly participating in inferior/less
expensive plans that could lead to healthcare-related financial crisis or bankruptcy down the
road (by striking down annual and lifetime limits, deductibles on preventive care, preexisting
exclusions, etc). According to the Consumer Financial Protection Bureau, “Roughly half of all
collections tradelines that appear on credit reports are reported by debt collectors seeking to
collect on medical bills claimed to be owed to hospitals and other medical providers. These
medical debt collections tradelines affect the credit reports of nearly one-fifth of all consumers
in the credit reporting system.”
(http://files.consumerfinance.gov/f/201412_cfpb_reports_consumer-credit-medical-and-nonmedical-collections.pdf)
Some are mad because they consider this a redistribution of wealth, or a socialist program.
What needs to be effectively communicated is that the ACA addresses many of the major
consumer complaints about health coverage in America without moving to a single payer
system, but it only works if everyone participates. We need to target this group with “What’s in
it for me” messaging, and that it’s an all or nothing situation to improve upon the issues that
concern them personally (like covering dependents, preexisting condition exclusions, medical
bankruptcy concerns, etc).
Some state that the costs of ACA mandated insurance are contributing to their bankruptcy
filings because they cannot afford the coverage. Congress’s support of the “Rubio clause” in
2015 didn’t help their plight, since it pushed major competitors out of the market and drove up
pricing. The bigger picture that needs to be painted is that without adequate health insurance,
they were already at risk for filing bankruptcy at a future point in time for a medical emergency.
Focusing on reducing the cost of healthcare in America is a better way to address their concerns.
With health insurance they at least have the opportunity to budget for the costs. The ACA may
not have ended medical related bankruptcy but it has certainly made a dent. The Kaiser Family
Foundation recently did a survey and found: “… roughly 20 percent of people under 65 with
health insurance nonetheless reported having problems paying their medical bills over the last
year. By comparison 53 percent of people without health insurance said the same… The
financial vulnerabilities reflect the high cost of health care in the United States, the most
expensive place in the world to get sick.”
Thank you for your time, and I truly hope you reconsider your position on this matter. Half of the
country is already upset about the gutting of the ACA, and the other half will eventually be upset when
they figure out what’s really going on. Brexit anyone?
Sincerely,
JoAnn Dolan, Colorado
Joann.dolan@yahoo.com
303-810-9924 (Cell)