June 19, 2018
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Repeal of health care law would be a mistake

By robert t. carlson

The U.S. House of Representatives is scheduled Wednesday to vote to repeal the Patient Protection and Affordable Care Act passed by Congress on March 23. There has been much discussion about many provisions that are embedded in the legislation.

Those discussions, to name a few, include questioning the constitutionality of the mandate to have health insurance, implications for the insurance industry, which will be affected by being required to provide coverage for persons with pre-existing conditions, elimination of lifetime limits. Also to be discussed: developing uni-form coverage documents that can be understood by the consumer by comparing apples to apples, capping nonmedical administrative expenditures and allowing dependents to be covered under their parents’ coverage until age 26.

There are many more issues being debated and questions being asked. However, it appears that the major thrust is that the act is not a good deal for America.

What we believe is not in question is that the health care system in America is not only in crisis, it is unsustainable. While we are a world-class leader in medical education and technological advances (people with resources come to America for personal health care needs and complex treatments and-or surgeries), we rank near the bottom in comparison to other industrialized nations around the globe. And that is further exacerbated by the fact that we spend two to three times more than other nations per capita for less effective outcomes and higher morbidity rates.

The Patient Protection and Affordable Care Act begins to refocus the efforts of the health care system. It recognizes that if we are to lower health care costs, we need to refocus our efforts in order to deliver a very effective primary and preventive care model. We must not only do better, we need to ensure that all people have access to that primary and preventive care.

It is through the creation of patient-centered medical homes that we will be able to shift the focus from what medicine can do to you when you are broken to what you can do to direct your health care with the practitioner of your choice in order to stay healthy and out of emergency rooms and hospitals.

The major emphasis of the act is to create that change of direction. As president of the Maine Primary Care Association and Penobscot Community Health Care, I can share with Maine people the fact that the Federally Qualified Health Centers across our state serve one in seven Mainers and one in four people on MaineCare. That is approximately 200,000 Maine people.

The Community Health Center program nationally has had huge bipartisan support since its inception in 1965. This support is in large part because the focus is on providing access to high-quality and integrated primary and preventative care, regardless of ability to pay to all people. The Affordable Care Act recognizes that ef-fectiveness and has a goal of increasing the 20 million Americans served by Community Health Centers to 40 million in five years.

We in Maine are fortunate that Reps. Mike Michaud and Chellie Pingree voted to pass this legislation because it is a good deal for Maine people. Rep. Michaud worked with the White House during the process to insure the act deals with the real issues of the high costs of health care by refocusing our efforts to providing for and delivering cost-effective primary and preventative care, examining reimbursement for primary care providers as well as increasing the primary care work force.

Nationally and in Maine, we have demonstrated that the care delivered by Community Health Centers lowers the cost of care significantly. We are convinced that the act will undoubtedly undergo examination and revision where necessary over time. However, we believe that it is a major initiative to begin the process of driving health care costs down and that repeal would not be a good deal for Maine or the nation.

The Rev. Robert T. Carlson is president of Penobscot Community Health Care.

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