Wednesday, 31 October 2012

Obamacare vs. RomneyCare - Poll Results

The 2012 U.S. Presidential Election is coming down to the wire... less than one week to go... and it's finally time for me to weigh in on the Obamacare vs. Romneycare debate. More specifically, which man, as president, would be better for people with fibromyalgia?

Before I spout my opinion, let me tell you what YOU said.

In a nutshell, roughly half of all respondents felt that Obama would be better, one in four felt Romney would be better; and the remaining one in four either didn't know or felt there was no difference between the two men. To be honest, I find these results not at all surprising... and here's why.

To begin with, Romney himself, during this campaign, claimed that he was writing off anyone relying on government financial support... he was conceding them to Obama. What this means is that any of you who are receiving government assistance for disability or for unemployment, Romney doesn't really really value. He is already convinced you won't vote for him, and doesn't see this as a problem. How does that feel?

Second, although Obama's health care reform is not perfect, it is skewed towards helping those who cannot afford private insurance or who are otherwise ineligible for it. In my years working with many patients with fibromyalgia, I found that many were dropped by their private insurance carrier once fibro was diagnosed. Some individuals who continued to work, lost their insurance when their company switched from one insurance carrier to another, because each employee had to be approved before being covered. Others retained their insurance, but only for non-pre-existing conditions... so, if you had fibromyalgia before your company switched insurers, you were out of luck. Returning to a system that relies predominantly on private insurers, as Romney and Ryan intend (as a priority), will open all these cans of worms again for Americans with fibro, and many will lose their insurance one way or the other. Obama has fought to make sure those who can't afford or are otherwise ineligible for insurance still can get the health care they need (and, in his and my opinion both) deserve.

Also, as someone who has lived and worked as a physician in both countries, let me tell you a little bit about how insurers pay emergency rooms or clinics (as an example) for services, if you happen to go there. Hospitals and clinics generally have negotiated arrangements with insurers, so they pay only a percentage of the actual bill. For example, if you go to the ER and have an X-ray done, the charge might be $350 for the X-ray itself, but also $250 to cover the fee of the doctor who ordered it, and $250 for the radiologist who reads it. The final bill for that one X-ray, therefore, will be $350 + $250 + $250 = $850.  Wow, right?  BUT, if you have private insurance and they are billed, the hospitalmight only be paid $200, and yet the bill is considered paid. But what happens if you DON'T have private insurance and, hence, DON'T have a pre-negotiated  arrangement for the hospital? Answer: You are on the hook for the full $850. It is for this reason that, despite Romney's and Ryan's assertions that the U.S. can't AFFORD universal health care, in fact, universal health care is less expensive... because hospitals and emergency rooms, and clinics and private physicians all have pre-negotiated arrangements with the universal insurance provider, so NO ONE has to pay $850 for an X-ray that the hospital is actually happy to accept $250 for. Evidence of this fact is that health care costs in Canada are much lower, per person, than in the U.S.... the two countries aren't even close. In fact, health care services in the U.S. are among the most expensive in the world. And does that make U.S. health care better? The answer is a resounding no. In a just published study, the U.S. was found to have the worst health care delivery system of any of the world's economic superpowers. Again, I truly believe that Obama's health care plan is intended to change this.

Another issue I'll discuss thaty favors Obama over Romney is their stance on women's issues, since fibromyalgia is predominantly a disease of women, with 80% or more of diagnosed cases being female. According to Romney and Ryan, women's disease screening procedures like mammography (for early detection of breast cancer) are 'non-essential' and should not be covered by insurers. Though long considered an 'invisible disease', the truth is that we now have the technology (via specialized imaging scans like SPECT and functional MRI) to SEE pain, and considerable research is being conducted at several centres around the world to refine such tests, as well as to develop blood tests to facilitate in the diagnosis of fibromyalgia. This is a critical issue because one in four doctors in North America still believes that all fibromyalgia patients are faking. Once an objective test is available to diagnose this disorder, many if not the vast majority of these naysayers will become believers. But if Romneycare won't even cover a long-standing, routine and relatively inexpensive screening test for breast cancer, what chance is there it will spring for ANY of these new tests for fibro? Answer: virtually none.

I pride myself on being a fairly balanced and even-minded person; so I would like to say a few nice things about Romney here; but frankly, in terms of the fibromyalgia and chronic pain issue, I just can't see them. Each person who reads this must make their own decision. But I've made mine as a dual citizen who is eligible to vote in both Canada and the U.S., and as a physician, researcher and staunch fibromyalgia patient advocate.

I'm sorry, Mitt. But Obama and Obamacare have my vote.

Kevin White, MD, PhD, multiple award-winning researcher, author, teacher & speaker

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