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The attempt to repeal and replace Obamacare (ACA) failed. I don’t think there is one person that can confidently say they even know what was in the last revision of the proposed American Health Care Act. Politicians were so desperate to pass the bill, changes were being made faster than it could be revised on paper. What was certain was that the bill did not meet all the Trump administration mandates: that it provided “Affordable coverage for everyone; lower deductibles and healthcare costs; better care; and zero cuts to Medicaid.” Even though the various revisions of the bill failed to meet any of these mandates, the administration supported it.
This was purely political. It failed because it was wrong. It failed because after seven years of complaining about Obamacare, the Republican congressmen STILL had no plan to replace it and threw something together last minute. It failed because enough Republican congressmen refused to be bullied (to vote for it) and pledged to vote their conscious, in favor of what was best for their constituents.
Nothing about this congressional effort focused on the good of the American people. It was never about quality healthcare. It was ALL about repealing Obamacare- destroying Barrack Obama’s legacy. That was the single goal.
Bad, Better, Worse?
In order to discuss the cost and accessibility of healthcare, here are some thing you might want to consider:
- The Affordable Care Act (ACA) and the failed bill, the American Health Care Act (AHCA) are/were both flawed. The combination of coverage, cost control and availability do not work in favor of the American people under either plan. Still, had the ACA been replaced with the AHCA, 24 million Americans would have lost coverage. A big problem with the ACA is that the model (ratio of insured) hasn’t been reached, driving premium costs up.
- Without regulation, healthcare providers are at liberty to charge uninsured patients whatever they want. Insurance companies have a stringent table of fees it will pay for services, yet it can vary from provider to provider, affecting individual premium costs.
- Healthcare insurance policies vary so greatly that it’s nearly impossible for the average American to decipher. This leads to confusion, inadequate coverage and unnecessary higher out-of-pocket costs.
- Healthcare coverage is more a subsidy than it is an insurance policy. Most Americans would not be able to afford quality care, especially in the situation of an emergency or long-term illness without some sort of assistance. Paying out-of-pocket is simply not an option.
- Half (or more) of individual American bankruptcies are attributed to debt from medical expenses.
- Public and private hospitals alike are prohibited by law from denying a patient care in an emergency. The Emergency Medical and Treatment Labor Act (EMTLA) passed by Congress in 1986 explicitly forbids the denial of care to indigent or uninsured patients based on a lack of ability to pay. (from Google)
Taking the above issues into consideration, if we are guaranteed treatment, with or without coverage– who pays? We all do. Whether through higher taxes, bankruptcies, rising premiums or out-of-pocket. We will all pay for healthcare for everyone.
As long as healthcare is for-profit in America, any efforts to make it affordable are likely to fail.
Here’s one example of a for-profit problem: Mark Bertolini, Chairman and CEO of AETNA received $27.9 million in compensation in 2015, up from 15 million in 2014. The combined compensation of four other top AETNA executives was $18.7 million, not including $17.4 million in restricted stock and stock options. In spite of a huge profit margin and exorbitant compensations for top level executives, AETNA withdrew from the ACA marketplace in eleven states this past year, to assure their financial gains. From 2015 to 2016 their net profits rose 8% to $603.9 million dollars.
We are told they can’t sustain services because Obamacare doesn’t work. In reality, it’s about greed.
Life, Death… Corporate Greed?
When the actual healthcare professionals that you and I are likely to come in contact with– such as EMTs, nurses, doctors and medical office staff– have problems affording adequate health coverage– there is a serious problem with the system.
There are really only three possible options, I can think of, to bring costs under control and make healthcare in America affordable:
- Heavy government regulation of all healthcare in America.
- Make all healthcare nonprofit.
- Establish a single payer national healthcare system.
None of these are easily fixes. What other solutions can you think of?
Washington may be willing to push this issue to the side (for now) but the problem isn’t going to go away.