The Presidential Election and the Effect on Healthcare

I normally don't do this. Even with people I speak with in person, I don't get very political. Partly due to the effects of being a blue dot in a red state, partly out of actual politeness and avoiding arguments, and partly because I don't think that most political discourse has an effect on how people actually vote. But as should be obvious from the title and the disclaimer thus far, I'm going to go there today. You have been warned. (as always, I'm sure that my employers -such as they are- and state associations that I am a member of have no voice in what I write, and the views are purely my own)

My father is an economist/history teacher and political discussions were the norm in our household from a young age forward. I now spend a good deal of time interfacing with our state lobbyist regarding how we can best protect and promote OT in my role as VP of Advocacy. I am a registered Democrat, but would more accurately describe myself as a political cynic. I think yard signs should be banned for anyone running for a higher office than the state legislature. I think that the debates should be abolished since they only serve as moments to spit out talking points, cherry picked statistics, and are altogether worthless until you see the Fact-Check. I get super irritated watching both candidates move closer to the center as election day nears and simultaneously knowing that a third-party candidate has no chance at all in going far enough to keep the other two honest. Don't even get me started on the rights of a SuperPAC.

So I pay attention to things. And I have to say that I'm disappointed in the campaign so far from both sides. Obviously the negativity does not make for optimal TV viewing (all hail Netflix and DVR!) but even from a purely strategic point of view I think that both have made serious errors. The campaigns have chosen to push  repeatedly on little buttons when they had larger ones at their disposal. And from the ads in my region, you'd think the entire election was about abortion, and nothing else. I hate hearing how "this is the most important election of all time" or "this election will change the course of history" or "we couldn't last four years with X". It's all ridiculous, and a lie.

But there are still legitimate topics that will realistically concern people in the coming years. Healthcare should be of large concern for everyone, since it is a service that everyone will eventually need to use, a funding source for many of us, and affects the quality of life for our families and clients. So knowing how the candidates intend to approach healthcare (and reform, because the cat is already out of the bag) is important.

You've heard what they say- "The (insert party here) is trying to destroy Medicare as we know it!" But both sides have proposed changes to how the healthcare system will work. I say system and not just Medicare because Medicare is the driving force behind how other insurances set their coverage and rates. And it's not fiscally solvent. As the baby boomers age, we will have a larger number of people to insure, who are living longer, and fewer workforce members (to both tax and charge higher commercial premiums)- this is a recipe for bankruptcy. Change is no longer optional.

Both campaigns have essentially proposed similar tactics, which shouldn't be surprising if you consider that the ACA was drawn around Romney's plan instituted in Massachusetts. However, they continue to parse words (vouchers! exchanges! Obamacare!) in attempt to make the differences seem more drastic. Both plans would allow you to take federal money to purchase insurance from a marketplace that offers the minimum Medicare/federally defined benefits. The ACA proposes to re-prioritize Medicare monies to start some of the funding for their tasks, and intends to cut costs long-term through preventative care and a board of advisers who propose strategies to cut costs without cutting benefits. There are some lofty goals, and it will be interesting to see how we simultaneously shift to prevention and wellness while cost-cutting. The Republican plan intends to make Medicare a pay-into contribution system, counts on competition to drive down costs, and the government pays a premium cost for any insurance and places overage costs onto the insured person. Unfortunately it becomes quite a gamble for the insured person if competition doesn't reduce costs sufficiently, since they wind up holding the bill, and remember that many Medicare beneficiaries are on a fixed income.

Both plans claim to reduce Medicare spending by the same amount. Neither method has been proven to work. Both plans rely on Medicare cuts- the Republicans intend to use that money for tax cuts and deficit reduction, while the Democratic plan uses that money to fund Medicaid. The word from the Republican camp was that Medicaid (like FEMA and other state-benefit programs) would need to become completely state funded without federal support. Being native to a dirt-poor state, I worry about the feasibility of making that happen without major cuts to an already strapped system.

This is what I think is important, and I base this upon the clients I have worked with over the years. So many of my families depend on Medicaid. If they do have insurance, many times one parent was effectively forced to stay in the same job for fear of not getting the child covered under a new plan due to having a preexisting condition. I have worked long enough to know that all it takes is one accident or completely unexpected health event (e.g. aneurysm, child's cancer,etc) to completely bankrupt a family with or without insurance. I believe in protecting the people who are most disadvantaged- children, the poor, the disabled, the elderly. So though there certainly isn't a perfect option at this point, no golden ticket to magic wonderful healthcare, my vote is to continue the ACA.

This is an important issue, and I would advise you to read more if it concerns you.  My sources:
Here's a rundown from Politifact on truthfulness of claims on healthcare.
This one is specifically on the ACA (Obamacare) and claims made by both sides.
and one more specifically on Medicare claims


Jeanie B said...

I do not discuss politics with any of my clients or people I come in contact with as a therapist. I feel it is unprofessional. I was surprised that you chose to speak out politically to those who signed up for your therapy blog. In my opinion, you took advantage of your subscribers. I have unsubscribed. Thank you.

Cheryl said...

I don't discuss politics with my clients because they are in a position of vulnerability. I've discussed this before and have not altered how I interact with anyone in my position as an OT. My views do not affect the treatment I give to my clients or how I interact with my coworkers. But I am entitled to my views, and made it clear that I was sharing my opinions in this post. My "subscribers" are not paying for my writings and are free to do as they wish with their reading time, but it's unfortunate to immediately reject an entire blog based on one post.