Iowa U.S. Senate Candidates On Obamacare

Rep. Bruce Braley

Rep. Bruce Braley

At this stage in Iowa’s U.S. Senate race it is important to listen to the other side. Most voters are not engaged in one of the most visible political races in the country, and likely won’t be until much closer to the election. There’s time to turn the tide, and with the most recent poll showing the race in a dead heat, understanding what team Ernst is saying can help produce a win for Bruce Braley.

“We believe Obamacare is not improving healthcare in America, but making it worse,” said Republican candidate Joni Ernst on July 12. “We need, and must demand, more individual control over our health care decisions, not less. Parents and doctors know what’s best when it comes to the health of their child– not the government. We need to start over and create real, meaningful heath care reform that allows us– Americans to choose the plans they want, the doctors they need, at a cost they can afford.”

Where Ernst is dead wrong is that health care reform cannot be restarted. Health care is a complex system of education, technology, research and development, law, and capital investment as much as it is interaction between a patient and their doctor. By its nature, reform can only begin with the as-is situation, which includes the current legal and regulatory structure. She isn’t clear whether this statement intends to exclude some parts of the patient-doctor relationship with regard to women’s health issues. What is clear is her unrealistic expectations of what is possible with regard to health care reform.

As if consumer choices were the end-all, be-all in our Democracy. They simply aren’t, especially for people who live lives where buying a health insurance plan is not an option, even with substantial government subsidies. The choice is often between whether to go to the emergency room and delay payment on the bill, or do nothing when sick or injured. Set social injustice aside, the entire U.S. health care system is a bad deal for consumers.

On June 16, The Commonwealth Fund published a report on how the U.S. health care system compares internationally. What it found was the U.S. system was the most expensive, and produced the least favorable outcomes on most dimensions of performance among industrialized nations. It was rated last in terms of access, efficiency and equity. It is too early to tell if the Patient Protection and Affordable Care Act is working, although Ernst was quick to opine that it is not improving outcomes. As BFIA keeps mentioning, the ship has sailed.

The assertion that health care in the U.S. is not improving is an open question. Like some Democrats, Ernst wants to make claims before the data is in. The truth has no November deadline, and we will find out together. What we know is our fractured health care delivery system, consisting of private insurance, Medicare, Medicaid, the Veterans Administration hospitals and clinics, and other outlets is not working, is too expensive, and is inefficient. Obamacare, with its focus on access and the private insurance industry, won’t be able to solve those problems without further improvements.

What Ernst’s well-crafted statement represents is an effort to put the best possible face on extreme views. If a vote to repeal and replace Obamacare comes up in a Republican controlled Senate, we know what her vote will be. I’ve lost count of how many votes the U.S. House of Representatives has taken on Obamacare, but they don’t like it either.

In contrast, Bruce Braley’s position is clear:

Providing affordable, accessible and quality health care to all Americans is one of my top priorities. I was proud to help pass the Affordable Care Act, which will decrease health insurance costs, expand access to quality, affordable health care, improve reimbursements for Iowa medical providers and allow Americans to maintain their choice of health insurance. This bill will provide much-needed relief for thousands of businesses in Iowa’s First District and will reduce our deficit by more than $100 billion over the next 10 years and over $1 trillion in the 10 years after that.

Check out Bruce Braley’s web site here.

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