Monday, March 27, 2017

Out of the Ashes of Health Care

How ironic, that Republicans had successfully voted numerous times to repeal Obamacare, only to have the President veto the bill to do so.  And YET NOW that Republicans are more in charge and have the Presidency, they fail to pass a repeal.  WHY?  Democrats didn't hand Trump a defeat, CONSERVATIVES did because Trumpcare was in some ways as flawed as Obamacare.  A straight repeal would have made conservatives happy.

The Democrats may have been right about the merits of Obamacare, and the havoc that would have been wrought by “Trumpcare”.

Bob Shrum, a Democratic consultant and politics professor at the University of Southern California, said: “The truth is it might have been worse for him had it passed because he would have faced a potentially devastating midterm election."  It is being said that Friday’s debacle may yet be a blessing in disguise for the president. I still contend that Trump "walked away from the deal" and gained an advantage down the road.

Now the question I haven't answered for myself is how WE AS A NATION move forward with health care, since it surely appears that Obamacare will continue to fall apart without congress to rescue it.  We are likely to see many areas in USA where there is NO coverage.   So you will have people and businesses paying mandates and penalties and getting NO health care to show for it!  How much does that suck?

Maybe their won't be a comprehensive plan, such the ACA.  Perhaps health care is too complicated, controversial, and politically charged to be fixed in a big ACT of legislation.

Maybe we just get a series of new smaller bills and more minor legislation and regulatory changes, each of which addresses some issue with health care.  It is not as grand and conspicuous as some large bill, but maybe a new approach will emerge.  Perhaps it makes better sense to fix one piece at a time?  I am open to that for a variety of reasons.  Especially if it allows for greater bipartisan cooperation.

We might not like the fact that we need two systems.  One that is like Japan's non-profit system which regulates prices and limits coverage but costs 1/10 of the USA, AND covers 100% of their population. PLUS a second free market system that allows people to purchase added coverage if they can afford it.

And nothing will work if we don't drive down costs, speed up drug and device approval, change how we deal with end of life care,  reduce liabilities that raise insurance rates that are passed onto consumers, provide for new delivery systems such as pharmacy testing and vaccines, AND hold citizens to greater accountability for their own health!!

We need to recognize how external factors and trends such as marriage failures, poor wage growth and poverty, opioid usage, alcohol, cigarettes, etc effect health care costs.  Fixing our economy and robust wage growth will help!  Legalizing marijuana as an alternative to alcohol for recreational relaxation will help too.  Promoting a healthy life style and educating children on better health practices will help.  Many of the nations with lower mortality rates than America also have lower obesity rates!

Fair to say that Obamacare and the American Health Care Act are both going to be ashes by the time Congress is through. The question is whether a phoenix will rise from the mess that is American Health Care today.