So, When DO We Make Healthcare Affordable?

HEALTHCARE POLITICS--For all the talk among those who just haaaaate the GOP (and, in their open-minded tolerance, everyone who either is or leans Republican after evaluating the issues) and presume that the GOP hates "Obamacare" just because of its name or just because Republicans enjoy people not getting health care, let's face it:  health care costs are going up, and many are still uninsured (or in misery with higher premiums and drug costs). 

But while Republican answers to the question of affordability and true coverage have been too often deep-sixed by a press that's been the virtual/media "palace guard" of the President (for whom they still have drooling, fawning adoration, no matter how many coverups and screwups have occurred on his watch), IT WAS THE GOP WHO HAD A MAJOR ROLE IN THE HEALTH CARE AFFORDABILITY CRISIS TO BEGIN WITH. 

For years, the problem was brushed off with a "let the market take care of it" by the GOP, who were in the pockets of the health care/pharmaceutical the Democrats took it on when they had the power after the 2008 elections ... 

... and, apparently are also in the pockets of the health care/pharmaceutical industry.   

The lack of competition among ACA (Affordable Care Act)-participating health plans is awful, and it's painfully evident they wrote the bill for a Congress that didn't bother to read it.   

Drug costs are through the roof, and the number of uninsured is nowhere near fixing the problem that the Democrats and President Obama RIGHTFULLY acknowledged but failed to fix: 

1) Drug costs, including and especially generic drug costs, are outrageously and morally inappropriate, criminal in their excess, and fiscally unsustainable for this nation.  

Unlike first-rate pharmaceutical companies, which pay billions for research, education, free samples for impoverished patients, generic pharmaceutical companies (who were supposed to make medicine cheaper) do NOTHING of the sort except jack up costs as much as they can. 

When we allow generics to be sold as such (instead of up to 85-90% of brand-name costs) and reduce their allowable price to 25% or less of brand-name, only then will our lives be made better in the manner for which generics are priced. 

And NO ONE is looking into the unholy, incestuous relationship that major pharmacy chains have with these same repugnant generic companies (for which many of you, dear readers, may not be aware of)! 

Perhaps the outrage caused by a reptilian, amazingly-uncompassionate CEO who raised the cost of a medication to treat parasitic infections in HIV and cancer patients 5000% (just because he could) will call attention to this monster rip-off of American consumers and their health plans, and the dramatic impacts on health care that it has caused. 

2) With all sorts of health care costs (premiums, co-pays, medications) going up for a variety of reasons, the ACA is making ALL Americans more conservative about health care costs. 

Apparently when money gets thrown at health plans and pharmacy plans, fiscal prudence gets tossed out the window, consumers get hurt, and health care gets compromised.   

Immorality, greed and human nature still exists...who knew? 

But let's make something clear:  I've treated individuals who had no health care before the ACA, and it's wonderful to take care of them.   

Yet I've also treated individuals who cannot afford the ACA, "make too much" to benefit the ACA, or who under the ACA find health care too expensive--and the misery among those individuals is too overwhelming to ignore. 

3) Innovations in saving money and exploring unmet needs of patients and health care professionals still exist, if greed and close-mindedness can be pushed both parties. 

For example, free medical school (or nursing school, or what have you) to avoid debt and to establish required health care professionals in underserved areas has the additional benefit of freeing young professionals from making career decisions based on income rather than professional fulfillment. 

And subsidizing health care training isn't new--it's been around for years, and it's a heckuva way to save money compared to bribing debt-ridden professionals to serve in areas which have unmet health needs. 

And another way to help serve in areas with unmet health needs:  teledermatology, which allows cheap, high-quality postoperative care, home care, and distant care to remote locations where specialists and primary care providers do not exist in sufficient numbers. 

For too long, the "fixing" of health care was performed based on dogmatic political and philosophical reasons that had little to no pragmatic benefit for ordinary Americans. 

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As for the ACA?  Too many Democrats dancing in the streets, and too many Republicans crying in their beers. We've got too much work to do, and too many who are suffering, for any celebration or sulking. 

It's doubtful that THIS President and THIS Congress will fix the problem...but despite our challenges, it's hoped that after the 2016 elections we can then address the health care issues in a pragmatic, fiscally-prudent way to enhance the financial and medical health of our nation. 

(Kenneth S. Alpern, M.D. is a Westside Village Zone Director and Board member of the Mar Vista Community Council (MVCC), previously co-chaired its Planning and Outreach Committees, and currently is Co-Chair of its MVCC Transportation/Infrastructure Committee. He is a dermatologist with extensive clinical experience and a presence in Los Angeles, Orange, and Riverside Counties.  He is co-chair of the CD11Transportation Advisory Committee and chairs the nonprofit Transit Coalition, and can be reached at   He also does regular commentary on the Mark Isler Radio Show on AM 870, and co-chairs the grassroots Friends of the Green Line at The views expressed in this article are solely those of Mr. Alpern.) 




Vol 13 Issue 78

Pub: Sep 25, 2015