Scott A. Edmonds, OD, FAAO, focuses his blog on the role of the optometrist in health care reform – moving from primary eye care to primary health care. He is the chief medical officer of MARCH Vision Care, the co-director of the Low Vision/Contact Lens Service at Wills Eye Institute in Philadelphia and a member of the Primary Care Optometry News Editorial Board. 

Disclosure: Edmonds is a consultant for March Vision.

BLOG: Fixing the Affordable Care Act

After years of bluster and posturing, the Republican members of Congress are finding that “repealing and replacing Obamacare” is not quite as easy as talking about it.

There are a number of inherent conflicts in the very concept of a free market health care system that only some type of compromise will be able to solve. Too many of our elected representatives view the related issues as black and white and have been unwilling to look at innovative ways to improve the current law.

Some of the conflicts of a free market health care system are: Our citizens want comprehensive health care but either do not want or cannot afford to pay for it; our culture has evolved around an insurance-based system that focuses on the management and treatment of medical problems rather than health education and prevention of disease and injury; too many of our citizens view healthcare as a commodity that should be purchased by each individual when needed.

To organize an effective free market health care system, there must be certain basic elements of the system that are universal and certain elements that can be purchased to build to as much comprehensive coverage as desired by those who can afford it.

The crafting of the system to allow for both basic health care rights for all citizens and free market options is the role of the Federal government as designated in the Constitution with the phrase in the Preamble that states: “promote the general Welfare.”  Like safe roads and clean water, basic health care is required for any modern society.

There are two sides of the equation that need to be balanced to fix the current law.

The fight about whether to amend the current law or repeal and replace is political nonsense and amounts to the same thing.

The first side of the equation is the funding of the universal coverage. This needs to be done with a tax system that provides incentives for health and wellness and penalties for high risk or unhealthy choices.