Arkoosh discusses the Affordable Care Act

At an ap­pear­ance earli­er this month at the Ry­dal Park Con­tinu­ing Care Re­tire­ment Com­munity in Jen­k­in­town, Dr. Valer­ie Arkoosh gave her in­sight and ana­lys­is of the Af­ford­able Care Act, of­ten re­ferred to as “Obama­care.”

The 70 or so seni­ors in at­tend­ance listened as Arkoosh — a Demo­crat­ic can­did­ate in the 13th Con­gres­sion­al Dis­trict — out­lined the law’s ef­fect on Medi­care in par­tic­u­lar, and health­care spend­ing in gen­er­al.

“There are very op­tim­ist­ic signs that we’re start­ing to con­trol our health­care spend­ing,” she said early on.

The law is a risky top­ic for a Demo­crat­ic can­did­ate to dis­cuss: Ac­cord­ing to a Feb. 4 Gal­lup poll, 51 per­cent of Amer­ic­ans do not ap­prove of the law, with only 41 per­cent in fa­vor of it.

And the Na­tion­al Re­pub­lic­an Con­gres­sion­al Com­mit­tee reg­u­larly at­tacks the law as a Demo­crat­ic fail­ure, tout­ing money siphoned from Medi­care and Medi­care Ad­vant­age, and point­ing to thou­sands of people who lost their health-care plans as a res­ult of the law. 

But Arkoosh has a big stake in the ACA: She helped shape it. 

As pres­id­ent-elect of the Na­tion­al Phys­i­cian’s Al­li­ance, Arkoosh met with law­makers in 2009 and 2010 to provide her per­spect­ive as a doc­tor as they began draft­ing the law.

Since then, she has been reg­u­larly mak­ing ap­pear­ances like the one on March 4, when she fo­cused heav­ily on the law’s ef­fects on Medi­caid, Medi­care and Medi­care Ad­vant­age.

In gen­er­al, the ACA es­tab­lishes no co-pays or de­duct­ibles for well­ness vis­its, and makes it easi­er for people to get pre­vent­at­ive ser­vices reg­u­larly throughout their lives. In do­ing so, it strengthens “qual­ity versus volume of care,” she said. 

Even­tu­ally, Arkoosh con­tin­ued, less Medi­care money will be spent on people who need to “catch up” on treat­ing health is­sues if they sud­denly have the be­ne­fits after not hav­ing in­sur­ance most of their lives.

Even in the short run, she said, the ACA has “only very pos­it­ive ef­fects on the Medi­caid sys­tem,” and “pro­tects and strengthens” Medi­care be­ne­fits. She also poin­ted to a re­cent ed­it­or­i­al in which she urged Pennsylvania Gov. Tom Corbett to ac­cept fed­er­al money to ex­pand Medi­caid, cit­ing stud­ies show­ing it could cre­ate tens of thou­sands of jobs in the health­care field and save the state bil­lions of dol­lars over the next 10 years.

“That’s bil­lion, with a ‘b,’ ” noted Arkoosh.

It also be­gins to close the “dough­nut hole” in Medi­care Part D -— a pro­vi­sion that forces be­ne­fi­ciar­ies who need between $2,930 and $6,657 monthly for pre­scrip­tion drugs to pay 100 per­cent of those costs out of pock­et. Un­der the ACA, that hole is now $2,850 to $4,550.

The pro­vi­sion ori­gin­ally was writ­ten in “as dumb a way pos­sible,” said Arkoosh, and one that the ACA is start­ing to ad­dress. Now, those in the “dough­nut hole” re­ceive dis­counts on drugs, and ac­cord­ing to pro­jec­tions the hole will be closed by 2020. 

While the present­a­tion was gen­er­ally well-re­ceived, some still had doubts about the law’s cred­ib­il­ity.

“I do not be­lieve the fin­an­cial as­pects of Medi­care are go­ing to be achieved,” one res­id­ent said dur­ing a ques­tion-and-an­swer ses­sion after the present­a­tion. “The trans­ition has been ab­om­in­able and the lead­er­ship poor. The pub­lic is fed up with [bad] in­form­a­tion or out­right ly­ing.” 

In re­sponse, Arkoosh acknol­wedged the botched roll-out of the on­line health in­sur­ance mar­ket­place health­ in Oc­to­ber, say­ing she was “pretty dis­s­a­poin­ted” and “a little sur­prised” at how badly it went. 

However, she also ad­ded that the “amount of mis­in­form­a­tion [about the ACA] has been over­whelm­ing,” and that many more fa­cets of the law were en­acted seam­lessly. 

“When people hear a set of facts, they are al­most al­ways pleas­antly sur­prised,” she said. ••

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