Otis Brawley: Praise for the ACA Till the Ideal Comes Along

Democracy is the worst form of government — except for all the others. So the saying goes.

Otis Brawley’s opinion of the Affordable Care Act is similar.

“Is the Affordable Care Act perfect? Absolutely not. It is better than almost anything I have seen so far,” Brawley said in a recent video interview with Managed Healthcare Executive® editors, Briana Contreras and Peter Wehrwein.

Brawley, a professor of oncology and epidemiology at Johns Hopkins and former chief medical and scientific officer for the American Cancer Society, recently joined the MHE’s editorial advisory board.

In a wide-ranging conversation with Contreras and Wehrwein, Brawley’s qualified endorsement of the ACA came with observations about the law’s positive effects — and pointed criticisms of its opponents.

Related: Otis Brawley’s Split Screen: Racism, Lack of Caring — But Hope in the Response​

“There are a number of studies out there that demonstrate that people are not dying because of the Affordable Care Act,” Brawley said. “There are a number of studies out there that demonstrate that people are not suffering because of the Affordable Care Act. By the same token, there are studies out there that indicate that there is more death and more suffering in states that have not expanded Medicaid under the Affordable Care Act versus the states that have. All the studies are out there.”

Brawley noted that other large federal government programs, such as Social Security and Medicare, have been continually revised since they were enacted.

“The Affordable Care Act was instituted a little over 10 years ago and it has not had the opportunity to be tweaked and changes and modified because one party keeps on saying, ‘no.’”

Brawley had some barbed observations about states that haven’t expanded Medicaid. “The places have not expanded Medicaid under the Affordable Care Act— those are states that weren’t doing very well with health care to begin with. Interestingly, they are frequently red states. That is interesting conversation. Why is it states where people don’t seem to care about each other tend to be overwhelmingly Republican? That is an interesting question.”

Still, Brawley said he is not necessarily pro Affordable Care Act, and he spoke of an ideal: “I am pro some program or series of programs that gets every human being the health care that every human being deserves.” He staked out a similar position on Medicare for all: “What I am in favor of is all people having access to health care.”