We’ve had a dysfunctional health care system and an equally dysfunctional legislature for so long that I have decided to revisit something I wrote five years ago. For something so basic as an ability to obtain and sustain the provision of health care to all, “we the people” remain either tragically hopeless, or utterly clueless to what is best for all of us. Our $9,450 spending on health care per capita is twice as much as the next developed country, but we still leave over 25 million under or uncovered. While health insurance may be a privilege, health care for all who require it is a right; while it seems nobler to hand its reign to the people in the truest sense of capitalism, or a debatable interpretation of the founding fathers’ collective wisdom, deep into our hearts, when we are alone and able to shed our conservative and liberal shells, we all know that without an expanded public option, it is a notion which is not only inconceivable but frankly, downright lunatic.
While, it was heartening to see it return as a major issue for discussion during the presidential debates, the major fiasco surrounding the failed attempt to “repeal and replace” has told us a few things:
a.) ACA may be deeply flawed, but it is a pioneering effort and the best option we have got right now.
b.) ACA needs improvements, and desperately
c.) No one in congress has any clue about how to fix it
d.) Despite years of opposition and many attempts to repeal, there is no viable alternative plan
e.) Our representatives have failed to recognize the importance of health care reform that caters to the people and not to the party line and lobbies.
f.) Health care is very complicated!
Imagine a perfect society where the government works solely for the benefit of the people; political gains, dashboard forecasts and corporate lobbies are just an afterthought. In that system, bills are presented and subsequently passed, not on the basis of party lines but for people. In that perfect system, health care gets the due attention that it truly deserves and a bipartisan commission will be created:
1. Three members of the house and two senators from each side of the floor, selected for their knowledge and expertise in health care and economy, rather than influence.
2. Two leading economists and health care policy experts, one of each nominated by the DNC and GOP.
3. Secretary of Health and Human Services or a senior authorized representative.
4. Two members of National Governors Association. One Republican and one Democrat.
5. Any member of the commission with direct links to any beneficiary group or lobbies (AMA, Trial Lawyers, Hospital conglomerates, Insurance and Pharmaceutical lobbies, etc.) will be automatically disqualified.
The failed attempt to “repeal and replace” was ... rooted in political malice rather than in the spirit of fixing what is truly broken.
Once established, the sole responsibility of this commission will be to come up with a solution to our health care problems. There will be a solid deadline for the presentation of a draft, which will be final. The commission will be sequestered during the deliberations with no access to any outside pressures, media or otherwise. Any leaks will result in immediate removal.
This is the only possible way that partisan attitudes of the congress can be overcome. If this works, it can be expanded to tackle other issues of national importance such as cost of higher education, so that the juvenile infighting of grown men and women has the least impact on decisions that we cannot afford to delay.
Despite being landmark legislation, the current shape of Affordable Healthcare Act has many flaws. Unfortunately, these flaws are a direct result of partisan pressures from both sides of the aisle, influenced by strong lobbies. The result is a lukewarm effort to tackle one of the most critical domestic challenges that we face outside of economy. There is still no clear evidence that the private sector will oblige and lower the rates so small businesses and patients are able to afford the premiums. In anticipation of this, the insurances have already tightened the noose around their coverage as medications, investigations and treatment plan have become increasingly more difficult to get approved, adding to the woes of a shrinking force of primary care providers, already burdened by the increasing cost-reimbursement ratio.
Health care providers however, are not the innocent victims either. The paranoia that surrounds them, stemming from the fear of a lawsuit drives them to frenzy when prescribing medications and tests, which on most occasions are more to protect themselves and pacify patient demands as opposed to leaning on clinical indications. Despite my own recognition of this habit, and its impact on health care spending, I am at times as guilty of unnecessary caution as the next guy. A tort reform that safeguards the rights of the patients as well as health care providers, giving them a sense of security and confidence in exercising their reasonable clinical judgment is a must, and its conspicuous absence in Obamacare is a cause of concern. In addition, with the help of insurance companies and especially Big Pharma (using a part of their direct-to-patient advertising budget), better education of health care beneficiaries, so they fully understand that expensive testing is not necessarily the best way to improved health, and is vital in order to achieve a more responsible and health-care-conscious society.
While we will arguably never see the fairy tale scenario detailed above, we can, for once, engage in a civil conversation about what’s best for the people. The failed attempt to “repeal and replace” was a mistake as it was rooted in political malice rather than in the spirit of fixing what is truly broken. However, it has open eyes on both sides of the aisle; the iron is hot for someone to take the helm of this meandering ship. Even President Trump promised it, “[people] can expect to have great health care. It will be in a much-simplified form. Much less expensive and much better… lower numbers, much lower deductibles.” The only way to do this is to expand funding for primary care physician training and safety-net clinics, introduce a low-cost publicly funded option to compete with the private sector to drive the prices down. A strictly nonprofit version of health plans that people can buy into without fearing sky-rocketing premiums. It is time to strike the iron while it is still hot, and before it is too late.
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