Saturday, February 26, 2011

Women Health and the politics of repealing the Patient’s Protection and Affordable Care Act (PPACA)

Keywords and Terms: Public policy; Politics; Health Care; PPACA; State and federal budgets; Deficit Spending; Republicans; Women Health

It is always a daunting task to comment on a public policy that has implication for the health of a huge sector of our population. The debate over the relevance of the Patient’s Protection and Affordable Care Act in a time of austerity is deeply felt, intellectually and emotionally. The daunting task of explaining to skeptics that the 111th Congress meant well when it passed and the President signed into law the Patient’s Protection and Affordable Care Act (PPACA) comes out of the risk of losing out on a subject that has beleaguered the nation for decades: health care reform. The effects of the failure of the American health care system before the advent of PPACA, are demonstrated by tragic reports in daily news that women health suffers just as much as children's, and any machination that will adversely impact the quality of care women receive in hospitals, clinics and specialty-care centers, has the potential of impacting their children too, including the quality of both lives.

My comment on the blog today focuses on two themes. The first is the question of how relevant is the issue of federal or state budgets deficit to the end health care services received by women and children in the absence of the Patient’s Protection and Affordable Care Act (PPACA). The second is the issue of politics with respect to the current drive by Republican lawmakers to defund the Patient’s Protection and Affordable Care Act (PPACA) and the implementation of its provisions. I ask if, in the pursuit of political scoreboard’s advantage, PPACA is defunded, would Republicans feel better? Will the kind of potential health care deficit that millions will suffer be justified by Republican Party political power gains?

For whatever it's worth, the imaginary political gains sought by Republicans in their recent effort on capitol hill, is minuscule. Further, by nature, the imaginary political power gains anticipated are often transient and even at that, many of those political power gains often erode after one or two elections cycles. Thus, the brouhaha that we are having from Republicans regarding their efforts to defund the Patient’s Protection and Affordable Care Act (PPACA) is best described as selfishness and worthless. Their gains, if at all they are able to accomplish the selfish act, will be ephemeral and offensive to many interest groups in support of better women health. What is additionally disheartening is that by the time any new congress could arise to do something about the huge damage to women and children health because of the defunding of the provisions in the Patient’s Protection and Affordable Care Act (PPACA), it is often too late.

On the issue of federal and State budget deficits: Several decades of deficit spending both by the two levels of government cannot account for defunding a one-sixth sector of the total economy. All the reckless waste spending at the federal level on irrelevant wars would not bring back zillion of dollars that could have been spent on a domestic issue, like public health, especially on women and children health. More money has been spent on foreign wars than have been spent on eradicating heart diseases in women, the number one killer of women, infant mortality or finding cure for breast cancer in past half a century. Women have often not held managerial positions long enough to be able to change the course of spending on defense and US wars overseas.

Several billions of dollars have been devoted to wars started by Republicans and their Whitehouse occupancy. While the portion of the national budget that goes into fighting wars continues to quadrupole, just a fraction of the budget spent at the Pentagon has gone into finding cures for war injuries, not to talk of diseases as cancers and leukemia, diseases that have destroyed many homes, killed many women and changed the course of lives for many men and their sons. Yet Republicans want to defund the first step at ensuring that the quality of health services received by women and children are as good as what obtains in Europe and probably in some Asian countries. Indeed, it is gross irresponsibility for any lawmaker to aspire to defund any provisions of a health care law that could bring about improvement in the care received by Americans and their households.

Forensic investigations to several states budgets will provide explanations why so many states’ budget are in deficit. The wastes in multiple layers of bureaucratic administrations found in some state’s agencies make budget deficits inevitable. The fragmented and indisputable non-chalet attitude towards how human and money resources are allocated in many State Agencies, both managed under Republican and Democratic Administrations, liter the history of budget woes in many states. The dulling of essential work of state’s agencies’ expenditure oversight and imprudent budget management practices are part of the structural deficits found in many states' budgets. The need to shore up State budgets has now been translated to an affront on public union employees and health care programs delivery; rather than attempt to protect and preserve programs that serve many of the vulnerable groups among us. Republicans are seeking to damage the little safety net that is available to the poor, the disadvantage and the oppressed. An effort to defund the Patient’s Protection and Affordable Care Act (PPACA) is an affront on any decency that is left in Republican lawmakers.

I agree that there are some provisions of the Patient’s Protection and Affordable Care Act (PPACA) that could be improved. Yet I detect a sense of 'pull-it-down' for us to gain some political points in the current effort of Republicans to defund the Patient’s Protection and Affordable Care Act (PPACA). Raising questions as to the authenticity of Republicans to support and provide legislation that serve the needs of the public is in order at this time. In the current effort in the US House of Representatives, there are concerns and worries from some lawmakers and the public, especially advocates of women health, that the overwhelming impact of defunding the Patient’s Protection and Affordable Care Act (PPACA) will fall disproportionately on women and children.

The collective understanding is that a poor health care delivery system impacts the quality of life and health status of the disadvantaged members of our society, including older women who live a longer life than their male counterparts. Indeed, it was suggested by some groups that the current effort to correct for deficits in some state’s budgets have fallen disproportionately on women and their children in single households, especially in states where these women have relied on state subsidized health care support, as many of the associated programs in some states health delivery systems have be shelved or dropped. Untold volume of data on associated denials and discontinuance of basic health care programs at state level are available if anyone is in doubt. The discontinuance of the basic health programs in some states, programs that are the last point of defense for many rudimentary health cares for our growing children and population of single female heads of families, just make me whimper. Here, I am not talking about families who have other health insurance policies, but those who had depended totally on State sponsored or subsidized health care programs.

On defunding the Patient’s Protection and Affordable Care Act (PPACA) efforts by Republicans, I wonder whether these lawmakers ever consider that efforts as this always receive negative reviews, even by some of their supporters, when the impact of their efforts materializes. I wonder what Republican lawmakers will say, if they realize that some parts of the provisions of the law that were not implemented because of insufficient funds has led to deaths of women and children; or that the program had made a consumer protection program incapable of addressing the frauds found in the implementation of complementary programs. I detect a hint in some anxious conversations with doctors and hospital administrators, there is no way that it will be possible to deliver the best service to patients under a close to universal health care insurance system; or, police all the fraud found in the implementation of the health care system or health programs because of the politics of defunding parts of the provisions of the Patient’s Protection and Affordable Care Act (PPACA).

I see an increasing widening gap in the health care services delivered to women and children, when the Patient’s Protection and Affordable Care Act (PPACA)is inadequately funded or defunded. If Republicans truly have an enduring value for deficit reduction, they must work hard to find their wastes in other areas of the federal and state's budget; they must not balance the budget on the backs of women, children and least privileged members of our society. If Republicans are concerned about some provisions in the Patient’s Protection and Affordable Care Act (PPACA), they can seek to mend those provisions by introducing bills that correct for the shortcoming and not work, as they are currently doing, to railroad a useful and responsive law. And particularly in the future, if Republicans find that we may reallocate resources to better serve our public, even in the implementation of the Patient’s Protection and Affordable Care Act (PPACA), it is their prerogative if not responsibility, to help the nation do better by being constructive but not seeking to abrogate all the provisions of a law that is already delivering lot of goods to Americans.

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