Educating a nation. Obama;s legacy: “..weaving into the American fabric the notion that everyone deserves access to healthcare.”

The 1948 NHS was originally sold on reducing or replacing fear. In Place of Fear A Free Health Service 1952 Chapter 5 In Place of Fear. Now there is fear in patients, and equally worrying in staff. ( Whistleblowing and the NHS culture of fear. Times letters ) Obamacare or the AKA took away a large chunk of fear. The republican media may hold off the tide for a while, but eventually socially mutualised medicine,, in some form will come about in the US.

Courtney Subramanian for The rise of Obamacare. Why is AKA so popular?

 Nobel-winning psychologist Daniel Kahneman famously pioneered the idea that people tend to fear loss twice as much as they prefer gains.

Loss aversion, he said, is when people feel the pain of losing something more than they feel the pleasure of gaining something else, which can leave some wary of taking risks.

That could be why the threat of losing the Patient Protection and Affordable Care Act (ACA), known as Obamacare, has led to more support for the healthcare law than ever before.

Can Obamacare be repealed?

Why is Obamacare so controversial?

President Donald Trump has urged Congress to repeal and replace Obamacare, while Republican lawmakers have suggested they could do so before the end of the month.

But the congressional plan to remove Obamacare has been hobbled by the Republicans’ inability to present a clear replacement scheme, leaving some Americans unnerved as the healthcare law’s expiry date looms.

“People are looking at what they’re losing and it’s not clear what they’ll be gaining,” says Thomas D’Aunno, director of the health policy and management at New York University’s Robert F Wagner Graduate School of Public Service.

An uncertain future about the country’s healthcare is “playing into people’s stronger attachment to the ACA”, he says.

That sentiment is felt by Americans like Cathy DeLoach, who changed her mind on the ACA after her son was diagnosed with testicular cancer and her family spent $29,000 (£23,000) on treatment costs in 15 days.

“I stayed with him in the hospital and I had a lot of time to think about how grateful I was for the Affordable Care Act,” she told the BBC.

Mrs DeLoach, who did not vote for Mr Obama in 2008 and 2012, said she was not a fan of the law when it was first passed, but now worries for her son’s future.

“This really is something that could be so awful for so many people, and so many poor people, and it’s wrong.”

Image result for mutual medicine cartoon

How has public opinion shifted?

A recent Health Tracking Poll from the Kaiser Family Foundation found the highest level of favourability for the ACA in more than 60 tracking polls since 2010, when President Barack Obama signed it into law.

The poll found that 48% of Americans approved of the ACA while 42% said it was unfavourable.

At its lowest favourability in November 2013, just 33% approved of it.

Ashley Kirzinger, a senior survey analyst at Kaiser, said that while it is not a majority of Americans who share this view, the shift underscores American concerns amid a heated debate about its replacement in Washington.

A handful of other polls echoed these findings….

….”The single most important part of Obama’s legacy on the ACA is weaving into the American fabric the notion that everyone deserves access to healthcare.”

The fear of losing Obamacare has been exacerbated by a grassroots movement at town halls nationwide, where hundreds of constituents have aired their grievances to Republican lawmakers over Mr Trump’s policies – including the ACA’s future.

“Looking your representative in the eye and saying, ‘I am deeply concerned that I am going to lose my health insurance’ is a lot more powerful than a clever chant,” Mr Williams says.

Image result for social medicine cartoon



This entry was posted in A Personal View, Medical Education, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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