As the White House and congressional Republicans scramble to repeal and replace the Affordable Care Act with viable legislation that will earn enough votes in the House and Senate, I’m reminded of the past.
It was nearly seven years ago to the date when the ACA, aka Obamacare, was enacted. The first of many huge mistakes that would follow is that the landmark bill, while well-intentioned and politically courageous, sailed through without a single Republican vote. That bothered me a lot, and I blogged about it at that time. Now the Democrats are vowing to do the same to whatever eventually emerges in the vernacular as Trumpcare.
This is why I’ve long been a registered independent. Not since the days when Ronald Reagan and Tip O’Neil could hammer out compromises on issues of the day and grab a beer afterward has either major political party in the U.S. been able to work together in a respectful and bipartisan way that benefits the entire electorate. Citizens are sick of gridlock and deserve much better than the deck of cards politicians have been playing with in recent decades.
But I digress. Health care is serious business. Lives literally hang in the balance over this issue, and many of us are getting a raw deal in terms of sky-high premiums for which we receive very little value.The greatest irony of the ACA is that, despite reducing the number of uninsured Americans by about 20 million through public exchanges and Medicaid expansion it failed to deliver on the operative word, which is to make care affordable for the average American.
Of course, there are many explanations for that colossal failure. Namely: not enough young or healthy people signed up for coverage after being uninsured, federal mandates such as the medical loss ratio tied the hands of insurers, premium-stabilization efforts stalled and triggered litigation, nothing was done to curtail pharmaceutical spending and nonprofit cooperatives that were supposed to compete with commercial carriers in underserved markets collapsed when their funding source dried up.
Moreover, the health insurance market still largely chases the low hanging fruit associated with cost-shifting onto consumers rather than fix the root causes of expensive care, people don’t take enough personal responsibility or make healthy choices and doctor pay continues to be based on patient volume rather than outcomes – with wild variations that make the cost of leading procedures appear arbitrary and perverse. It’s also highly confusing and frustrating for consumers and large health care payers who lack simple and standard quality measures.
I had to chuckle upon recently hearing President Trump admit that repealing and replacing Obamacare is proving to be much harder than he anticipated. “Nobody knew that health care could be so complicated,” he said. You’re damn right it’s complicated!
And with that in mind, I can only hope that the White House and Republicans in both houses of Congress take their time before passing any legislation to fix current problems. I also hope that Democrats place love of country over partisan politics and be willing to not only accept responsibility for the ACA’s failures, but also offer their constructive input and compromise rather than obstruct when the time comes to seek a better solution.
Let’s finally get health care reform right. Our lives and wallets depend on it!