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Suzanne Somer's Blast of ObamaCare is MisguidedPosted on Nov 4 2013

By Meg Jordan

When Suzanne Somers recently blasted Obamacare for being a disaster, she spoke from the perspective of a wealthy, white woman, who has always been able to freely access and build resources and networks for her self-care. Ms. Sommers is a celebrity who could afford any number of doctors and treatments she wanted, and obviously does not represent the average person that Obamacare was designed to help. Obamacare is not perfect, but it's a step in the right direction, assisting the millions who can't afford a health plan or have been denied coverage for numerous reasons.

It is true that in some states in which the health exchanges are not fully operational (due to political stonewalling), problems in signing up will ensue for the next half-year or longer. But in the states that prepared early, have decent health exchanges in progress, the Affordable Care Act brings competent care to millions.

The insurance companies that are dropping customers are usually ones that have little market share (like United healthcare in California with the independent sign-ups), and don't want to compete with the larger players. They would rather drop out of the market, unload their sickest customers on competing firms, and yes, some folks (those who aren't in big employer plans) will be left uninsured--until they go to their local state exchange and buy some other, less expensive policy. These are the stories that are making headlines and allowing people like Ms. Sommers to present a half-version of reality.

All insurance firms are in the business of making money, whether they are granted special tax-breaks or not (Blue Shield and Anthem Blue Cross get those breaks in California). Because they all pool risk, the higher expenditures accrued by sicker patients are carried or cushioned by the low utilizers (healthier members).

When attempting to extend coverage to more people, certain strategies must be in place to control health care costs. One of those strategies is to function within tighter networks of hospitals, physicians and referrals. Kaiser has been an exemplary model of this closer knit bond, and was actually the first type of "medical home" conceived to be a 21st century solution to stem the tide of rising costs and eliminate fragmented care.

The type of care that highly privileged individuals pursue is often spread across several networks of providers. They want to go to one hospital several states away because of its prestigious standing in a specialty, while seeing their favorite doctors who may be participating in different networks at home. No private or public health plan can afford that sort of unchecked shop-around option for very long. It's exorbitant, inefficient, and also leads to over-medicalization and poorer health outcomes.

Health economists from Princeton to Stanford have demonstrated that single payer coverage is likely the most efficient model of health plan, but the US sick care-insurance system is deeply entrenched in a profitable model, that we will probably limp along for another century with this patchwork system, before succumbing.

Obamacare is not really health care reform. But it is a stab at reeling in the blatant abuses in the health insurance industry with some price and coverage reform. As a modest step, it is neither a life-saver (unless you've been dropped by your insurer for a pre-existing condition) or a "disaster" as Ms. Sommers would have you believe.

Check out your state health exchange. You may be surprised at how convenience and lower price the coverage is--that's my advice to my graduate students, one of whom found coverage for $19 / month in California.

As an elder in our community said, "Give Obamacare a chance. It's the mark of a compassionate society to want to take care of its sick, its infirm, its elderly and children. It's the mark of an immature and violent society that says, each to his own, the hell with the other guy."

Dr. Meg Jordan

Dr. Meg Jordan, PhD, RN, CWP, is Department Chair of Integrative Health Studies and Somatic Psychology at the California Institute of Integral Studies in San Francisco, where her focus is preparing graduate students as catalysts for positive change in health care, wellness and health promotion. Dr. Jordan is a clinical medical anthropologist, an award-winning international health journalist, behavioral medicine specialist, RN, author, and President of Global Medicine Enterprises, Inc.

 

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