MCMS Physician Winter 2017 - 14

mon t m e d s o c .c om

The Time is Now:
Repeal the ACA
BY STANLEY ASKIN, MD

M

edical care, like food, can take different forms and
mean different things to different people. We can all
agree that both are not only desirable but essential to
our individual and collective well-being.
As a society, we do not allow people to starve for lack of food.
We do not do so by commandeering the services or products
of food producers, but rather to appropriately compensate the
farmers and ranchers for their efforts to provide us with the
literal fruits of their labors.
In the book The Naked Ape, Zoologist Desmond Morris
analogized medical care to the grooming activities of lower
species. Certainly, interacting with your physician to manage
your diabetes or hypertension is more sophisticated than
monkeys picking nits off each other, but in practice much of the
hands-on healing that clinicians provide can be appreciated as
similar in nature.
If we were mere providers of technical expertise, there would
be no need for rapport or reassurance or handholding. By the
same token, when the medical concern under consideration
is something for which pure technical expertise is obligatory,
bedside manner takes a backseat to the surgical skills to replace
an arthritic hip, a diseased heart valve, or to the near-miraculous
skills of our modern oncologists who manage cancer to radically
improve outcomes for those in previously parlous disease states.
The sentiments that were presumably motivating for the
Affordable Care Act (ACA) seemed to overlook the actual
needs of patients. Certainly, for those requiring care of a purely
technical kind, we do not want people suffering from lack of
access to services that are essential. But that sort of need might
be best served by catastrophic insurance policies that assure the

availability of those services and be a true "insurance," much
the same way we insure our homes against a fire that we do not
expect. For those incapable of securing catastrophic care services,
Medical Assistance programs can serve this need, just as food
stamps stave off hunger.
For services of a grooming nature, it can be appreciated that
while such may be desirable, the need can be elastic or perhaps
more efficiently provided by physician extenders, without
necessarily disturbing optimal healthcare outcomes.
The ACA offered a procrustean approach to healthcare,
regimenting without discernment that which is obligatory from
that which may be desirable, in a command fashion that has
proven not only unexpectedly expensive, but unwieldy. Were it
likened to food, the Affordable Care Act would be like forcing
everyone to eat military style MREs (meals ready to eat) as a
government concocted formulation, at a cost over which the
consumer has no control, in order to keep us all nourished
whether we liked it or not.
It is understood that proponents of the ACA, such as
MIT Professor Jonathan Gruber and the political elites who
hired him, are well-meaning. But the ACA's enactment and
implementation have been un-American, and incompetent in
achieving its stated goals. Surely no one can say with a straight
face that the Affordable Care Act has made healthcare affordable
or less unaffordable.
The American electorate, obviously more intelligent than an
MIT professor, has taken the measure of the ACA and have
elected to reject this abomination.
Good riddance.

M C M S P H Y S I C I A N 14 W I N T E R 2 0 1 7


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Table of Contents for the Digital Edition of MCMS Physician Winter 2017

MCMS Physician Winter 2017 - 1
MCMS Physician Winter 2017 - 2
MCMS Physician Winter 2017 - 3
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