With the U.S. House set to vote today on a potential replacement for the Affordable Care Act, one of the country's leading experts on the delivery of health care spoke out on the issue at the annual educational meeting of the San Antonio Medical Foundation, News Radio 1200 WOAI reports.
Retired Rear Admiral Susan Blumenthal, the former U.S. Assistant Surgeon General, says Obamacare in many ways did what it was meant to do, drastically reduce the number of Americans without access to health care, and she says the Republicans would be better serviced to work on improving the existing plan rather than starting from scratch.
One problem that needs to be addressed, Admiral Blumenthal told the group, is to deal with the ability of young people to dodge buying health insurance by paying a penalty.
She says that makes the system unsustainable, because for it work, everybody, young and old, healthy and sick, needs to be part of the system.
"What happened is, one of the reasons why premiums go up, by having a mandate, but allowing people to buy out of that mandate by paying a penalty, a lot of younger people didn't go in, to spread the risk of sicker people."
She says auto insurance wouldn't work if the best drivers could avoid buying car insurance by paying a penalty. She says if it were only bad drivers in the system, car insurance premiums would skyrocket, with the same problems now being experienced by Obamacare.
She says another place the designers of the Affordable Care Act stumbled was in not doing what every other nation on earth does, and regulate drug prices. She says that allows the drug companies to recover the high costs of drug development only from U.S. consumers, instead of spreading that cost worldwide.
"We're the only country in the world that doesn't do it," she said. "We are also the only country in the world that allows TV ads for drugs."
She says when patients see a drug ad on TV, as many as 25% of people with the condition ask their doctor for that specific drug, even if the doctor hasn't recommended it, and even if it is unnecessary for that specific patient. That, along with a lack of regulation, helps drive up prescription costs.
Blumenthal says the higher costs of medical care are largely the result of the use of more technology, and that is something that can't be regulated without suppressing technological development.
She points out that when Medicare was unveiled during the Johnson Administration there were serious problems with that medical program as well. But lawmakers at the time resisted the urge to 'scrap' Medicare and replace it with something new, and now Medicare is generally regarded as among the most successful programs ever presented by the federal government.