Guest Column: Rooting for the Affordable Care Act

Kudos to the Burbank Leader for reminding us all why the Affordable Care Act was needed and the difference it will make in the lives of thousands of our neighbors who have been shut out of the health insurance marketplace for so long.

Unfortunately, since the rollout of the final piece of the ACA on Oct.1, it has been wrongly and prematurely assessed based on the technical glitches in its website, Anyone who has worked for a large corporation knows that the first days and weeks of a large, new system rollout can be frustratingly problematic. Thanks to the obstacles thrown in the path of development of the ACA and its online insurance marketplace by politicians at the state and federal level, its timeline was squeezed and financing insufficient from the get-go.

For comparison's sake, consider that Kaiser Permanente's highly-lauded, award-winning electronic medical record system, HealthConnect, developed to support healthcare delivery to 9 million Kaiser Permanente members, cost $4 billion and took 10 years to develop, while had only a three-year development window and thus far has cost less than $400 million. Luckily, California took advantage of the money and opportunity extended by the federal government to build its own system and has avoided most, if not all, of the problems experienced by the feds.

However, it is important to remember that even after it is functioning as intended, and will still only be the gateways to the marketplace — not the product of that marketplace. The products will be healthcare insurance plans from insurance carriers we are all familiar with, modified only to ensure that buyers know what they're buying and get real value from what they've bought. As an added benefit, through this marketplace, any individual or family with annual income below 400% of the federal poverty level will be eligible for significant subsidies to help them pay for it.

By the way, don't bother looking in this insurance marketplace for the “Obamacare” Health Plan — there's no such thing. To the disappointment of some, nothing in the Affordable Care Act authorized the federal government to go into the insurance business itself.

A fair assessment of the ACA should be deferred three or four years when we can evaluate:

The number and percent of our citizens who remain uninsured;

The reduction in costs to our hospitals of uncompensated care;

The decline in the number of bankruptcies caused primarily by unanticipated healthcare costs (the No.1 reason for bankruptcies);

The reduction in the incidence of communicable diseases, including the flu, thanks to greater access to preventive care;

A decline in the number of deaths in the United States each year due primarily to the lack of healthcare coverage (estimated to be 45,000 in 2009).

Finally, a word to those already insured who worry that they will now be subsidizing the uninsured through their insurance premiums: That's exactly what you've been doing for years, to the tune of about $1,000 per year. And what's worse, you've been subsidizing the most expensive, least effective care there is — emergency room care. When care for a condition that could have been treated promptly and easily at a cost of less than $100 in a physician's office is delayed until the uninsured patient shows up in the emergency room with an acute care crisis that costs $1,000 to treat, eventually we all pay. Uncompensated care is, in truth, just deferred compensated care — sooner or later, it shows up in the form of increased insurance premiums.

So for now, let's keep our eyes on the doughnut, not the hole, and root for the success of the Affordable Care Act in its efforts to bring healthcare in reach of millions of Americans.


RITA ZWERN, now retired, worked in the healthcare industry for more than 40 years. She may be reached by email at

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