On the campaign trail, President Trump promised to repeal the Affordable Health Care Act (AKA \u201cObamacare\u201d) his first day in office. When asked what he would replace it with, Trump\u2019s standard answer went something like: \u201cIt\u2019ll be fantastic; much, much cheaper than Obamacare and better coverage.\u00a0 Believe me; the American people will love it.\u201d He offered few details and the media never pressed him for any.<\/p>\n
After he was elected president, it became clear that he had no plan. But he still wanted to fulfill his campaign promise of repealing Obamacare immediately until Republicans in congress convinced him that repealing Obamacare without having something to replace it with would cause chaos for which the voters would surely blame him.<\/p>\n
Trump was clearly aggravated at the prospect of a lengthy delay, and he blamed Republicans for not doing their job and having a replacement plan ready to go. But the problem wasn\u2019t that the Republicans didn\u2019t have a plan; it was that they had too many plans and there was no consensus on which was the best.<\/p>\n
So the strategy became to nibble around the edges of the Affordable Care Act during the budget reconciliation process, when amendments to it could be passed by a simple majority and filibusters weren\u2019t allowed. This way Republicans could claim they repealed Obamacare when, in reality, they were rescuing a Democrat boondoggle that was rapidly imploding.<\/p>\n
Speaker of the House Paul Ryan assembled a select group of Republicans to determine which amendments they would propose during the budget reconciliation and promised a full replacement plan for Obamacare would be presented to Congress a few months down the road. The problem with this approach is that Ryan\u2019s plan accepts the basic premise of Obamacare that access to health care is a right and universal health insurance is the key to the government guaranteeing that right.<\/p>\n
But the expansion of insurance and other third-party payments such as Medicare and Medicaid are a primary reason healthcare costs have soared over the last 50 years. Congress enacted Medicare and Medicaid in 1966 as part of Lyndon Johnson\u2019s Great Society programs. At the time, 42 percent of medical expenses were paid by persons other than the patient; today that figure is 90 percent. Medicare now covers 45 million people \u2014 mostly the elderly and disabled \u2014 while Medicaid covers another 40 million low-income people.<\/p>\n
America is a generous nation and most people believe government should provide a social safety net for those in need. Medicare and Medicaid are classic examples of government simply throwing money at a problem. They put more dollars in the hands of nearly 100 million people who use them to bid for health care services. But they do nothing to increase the provision of those services.<\/p>\n
When more money is competing for a fixed amount of goods, the price is going to rise. Moreover, when someone else is paying for those goods, the higher price will not cause consumers to reduce their consumption of it: when a physician recommends a test or treatment, the patient is likely to ask if it will hurt and how long it will take; but they won\u2019t ask how much it costs or if there are less expensive alternatives.<\/p>\n
In fact, most people have no idea how much their health services cost because someone else is paying. According to a recent survey by Medscape, only 25 percent of physicians say they regularly discuss the cost of treatment with their patients.<\/p>\n
The only way to make health care more affordable and more accessible is to increase the provision of health services. The health care industry in the U.S. is over-regulated; cartelized by organizations like the American Medical Assoc.; and run for the benefit of providers. (Waiting to see a doctor takes longer than getting your driver\u2019s license renewed at the DMV or picking up mail at the post office.)<\/p>\n
There is a long list of reforms that would benefit consumers: allow pharmacies to publish and advertise the price of prescription drugs; allow health care insurance to be sold across state lines; open more medical schools so U.S. citizens can be trained for the highest-paying jobs in the nation.<\/p>\n
But don\u2019t ask the providers how to make their industry more competitive.\u00a0 Pharmaceutical companies, insurance companies, hospitals and nursing homes, the American Medical Assoc. and healthcare professions are among the largest lobbying groups in Washington, and they aren\u2019t spending their money to figure out how to provide more services for less money to consumers; they are spending it to increase their incomes and improve their bottom lines.<\/p>\n
President Trump has endorsed Ryan\u2019s amendments and is twisting arms and threatening Republicans in Congress to get behind them. If this were the only chance to reform Obamacare, one could argue these amendments are better than nothing. But tweaking Obamacare and using tax payer dollars to bail out insurance companies that helped design Obamacare is not what Republicans promised the voters. The longer Obamacare continues, the worse it will get. Republicans should use this to pressure moderate Democrats to get behind true health care reform.<\/p>\n","protected":false},"excerpt":{"rendered":"
On the campaign trail, President Trump promised to repeal the Affordable Health Care Act (AKA \u201cObamacare\u201d) his first day in office. When asked what he would replace it with, Trump\u2019s standard answer went something like: \u201cIt\u2019ll be fantastic; much, much cheaper than Obamacare and better coverage.\u00a0 Believe me; the American people will love it.\u201d He [&hellip<\/p>\n","protected":false},"author":19,"featured_media":1498,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[75],"tags":[1437,134,1436,80,1090],"yoast_head":"\n