Pictured above: (R) Dean Judith Ruland of the College of Health and Human Services at SVSU and (L) Marilyn Skrocki, a lawyer and associate professor of Health Sciences at SVSU.
HEALTH CARE: Re Obamacare -- "We Can't Go Back," Says SVSU Dean
April 5, 2014
By: Dave Rogers
Dean Judith Ruland of the College of Health and Human Services at Saginaw Valley State University summed up her view of the nationwide debate over the Affordable Care Act (a.k.a. Obamacare) -- "We can't go back."
Despite the political football being kicked from endzone to endzone, with advocates on defense and critics on offense --demanding repeal -- the game is on and can't be stopped, Dr. Ruland indicated in a talk at the Saginaw Valley Torch Club.
"We have come too far and so many people are benefiting that it would be impossible to consider repeal and starting over," said Dr. Ruland.
She teamed with colleague Marilyn Skrocki, a lawyer and associate professor of Health Sciences at SVSU, to break down the infinitely complicated law and developments radiating since implementation began three years ago.
She noted the fundamental change created by the law, often obscured in the fog of ideologically driven political rhetoric: "Paying for outcomes not services provided, providing better value for the premium dollar."
At the bottom line, the speaker asserted, is the contention by ACA proponents that the changes will result in 80 percent of the premium dollar going toward care of the patient while under the old system 65-70 percent went to patient care and the remainder to investors.
Striking to the heart of the matter is the assertion by proponents of the law that many doctors, hospitals and other health providers pile on scatter shot tests and procedures that create mountains of cost, diffusing focus on the patient's overall health.
Despite charges leveled in television advertising in a campaign for a Michigan U.S. Senate, the health insurance marketplace and federal tax credits will make insurance more affordable, according to the speakers. The campaign pits Democrat Gary Peters, a former Member of Congress, and Republican Terry Lynn Land, formerly Michigan Secretary of State.
In the advertising, a West Michigan woman, Shannon Wendt, contends that "Obamacare is not affordable," asserting that her health insurance premiums have risen and she can no longer afford them and can't get the doctor she wants. The ad has drawn national attention, and counter arguments.
According to factcheck.org: "It turns out that Wendt found a cheaper, subsidized plan on the exchange, but declined to accept it because she did not want her children on the Children's Health Insurance Program. That's her right, of course, but the ad is misleading because it fails to disclose that the Wendt family opted to pay more for insurance rather than accept the conditions that came with obtaining a cheaper, subsidized health plan on the exchange."
Notes National Journal: "Republican Gov. Rick Snyder has taken a more conciliatory approach toward the Affordable Care Act's implementation and pursued both Medicaid expansion and the creation of a state insurance exchange, the latter of which ultimately failed. And he was the only Republican governor who didn't sign a letter from the RGA (Republican Governors' Association) calling for repeal."
Likewise, State Sen. Mike Green, announcing recently for a newly realigned district of Bay, Tuscola and Lapeer counties, said only that "improving health care" was one of his priorities.
Michigan has a higher sign-up rate for Obamacare, 19.9 percent, versus the national average of 14.8 percent, said Ms. Skrocki. Many more Michiganians likely will join the system in the new enrollment period from November 2014 to January 2015.
"Most people qualify for a subsidy," said Dr. Ruland. Such entities as the Bay County Health Department will be providing care to individuals on a sliding scale or for no fee, she said.
Regarding the threat of fines for failing to comply with the individual mandate, Dr. Ruland said the government likely will waive penalties in most cases.
The speakers noted that the Henry J. Kaiser Family Foundation has explained the law and its effects:
On March 23, 2010, the Affordable Care Act (ACA) became federal law.
"It initiated the most significant changes in the U.S. health care system since Medicare was established in 1965," explains the Kaiser Family Foundation, which runs a huge health care insurance program, Kaiser Permanente.
"As an integrated health care delivery system covering more than 9 million Americans, Kaiser Permanente expects that the new law will affect its organization and the members served in many different ways.
Some of those impacts include:
Availability of coverage -- No one can be turned down for coverage because of a medical condition.
Expanded options for purchasing coverage -- All U.S. citizens and those lawfully present in the U.S. can now get coverage through the new Health Insurance Marketplaces.
More information at: http://healthreform.kaiserpermanente.org/
Some of the results of the law will be shattering to the present structure: much health care will be delivered by consortiums in "hub and spoke fashion" in places like shopping malls and patient-centered medical homes rather than hospitals, the speakers said.
Michigan now has 32 community health centers operating clinics at 194 sites. Experts, like those at the Cleveland Clinic, see consolidation and mergers to form collectives in the future under the new law.
Meanwhile, the increased number of people seeking health care has created a need for more physicians, with an estimated 500 more needed in Michigan alone, she said.
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