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ELECTION
FUNDAMENTAL FLAWS OF IMPACT
AFFORDABLE CARE ACT MUST BE ADDRESSED
By Bernard T. Swift Jr., DO, MPH
The election is over. The voters have spoken. Half the country is ACA is one such entitlement that is under fire for its failure to de-
disappointed in the outcome; but half was disappointed in 2008 liver on its many promised benefits, most notably its prediction to
and 2012. Whether or not you agree with the outcome, it’s now “bend the cost curve down.” In fact, costs are rising because the un-
time to get over it and move forward for the good of the country. derlying tenets of insurance are not being met. The healthy appear
to not be willing to pay the costs of insuring the unhealthy even
As a nation, we have waxed and waned over the years regarding though mandated to do so via required purchases. It’s that simple.
our governing philosophy. Over the next four years the changes are
likely to be substantial with a greater emphasis on growing the econ- The great social experiment of the ACA does not appear to be
omy and less emphasis on social justice. working out very well. Whether we “Repeal and Replace” or “Mod-
ify” is immaterial at this point. The fundamental flaws have to be
Healthcare has been one of the major divisive issues of our time. fixed either way.
Polls (if you can believe them now) have consistently reported more
than half the country doesn’t like the Affordable Care Act (ACA), As of this writing, there is a newly nominated Director of Health
although many support the effort to increase the number of Amer- and Human Services who will likely have enormous discretion over
icans who are covered by insurance. The issue is whether or not, as the direction of policy changes. Tom Price, MD is an orthopedic
currently written, the ACA is economically sustainable. Whether surgeon who will be on the forefront of identifying a path forward,
there is a wholesale “repeal and replace” or “modification” to the and his and Congress’ decisions will affect healthcare policy for all
ACA remains to be seen. What’s becoming clear is that the early of us far into the future. It remains to be seen as to whether or not
stages of the ACA’s predicted death spiral are beginning to play out. their ultimate plan will be cost effective, sustainable, and most im-
Unless fundamental change is undertaken, the ACA will not be sus- portantly gain the respect of the public it will serve.
tainable in coming years.
Bernard T. Swift Jr., DO, MPH is an Occupational Medicine physi-
We live in a society where it can be argued that the “culture of cian and is CEO of Texas Med Clinic.
entitlement” has exceeded the originally intended safety net. The
visit us at www.bcms.org 17
