This is a pivotal time for both political parties and the country, with far-reaching consequences into the future. Any GOP replacement or repair plan will fail, be unsustainable, and incur huge and unaffordable costs for taxpayers without the benefits that Americans need and deserve. The winners would be the private insurance industry, the drug industry, other corporate stakeholders in the medical industrial complex, and Wall Street. The losers would be patients and their families, who will have less access, choice, and affordable care, and face worse health outcomes.
Defying experience and reason, we can anticipate that the GOP’s principles and approaches will make an imploding ACA system even worse. We can then expect a huge backlash from the public and even the private insurance industry when it doesn’t get all that it wants.
Trump’s political appointees further show how unlikely it is that any swamp will be drained—instead, we can expect quite the opposite, and that doesn’t bode well for health care.
What will happen in Congress in January remains unclear. Democrats can ward off a filibuster in the Senate while the Republicans are deeply divided over the ACA’s repeal and replacement options.
We have three basic alternatives in how we finance health care: (1) continuation of the ACA with changes as needed; (2) repeal of the ACA and replacement by a GOP “plan”; and (3) enactment of a single-payer Medicare for All system of national health insurance (NHI). But you would never know that from the debate, which lacks details of the first two options and remains silent on the third.
The ACA bailed out the industry in 2010, which is once again calling for more government subsidies to stay in business. A just-released estimate by the Department of Health and Human Services (HHS) acknowledges that the three-year risk corridor deficit from 2014 through 2016 for insurer losses will exceed $14 billion. (4)
Medical students and their colleagues in other health professions are looking for a simplified system with universal access for all Americans to necessary care based on the principle that health care is a human right. That approach has been adopted for many years, in one way or another, by almost all advanced countries, while the U. S. remains by far the most expensive system with worse access and quality of care than most of these countries.
Despite grudging acceptance of EHRs by most physicians, they are here to stay.
Mylan’s EpiPen story is a classic poster child for continued corporate greed that knows no bounds.
Conservative politicians, including both Republicans and many Democrats, have long been wary of a single-payer public financing system for national health insurance (NHI). They go out of their way to denigrate the Canadian system, even though it is extremely popular in Canada since its enactment in the 1970s, is tied to a private delivery system, and is more efficient and less bureaucratic with better outcomes than our far more expensive system.
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