The Healthcare Quandary
Republican Congress members and President Trump can be heard gnashing their teeth apparently stumped on how to repeal Obamacare and replace it with something better. There seems to be no problems in finding ways to repeal the Affordable Care Act, but finding any plan to replace it is proving difficult for several reasons. I wonder why?
The Republican Party has objected to Obamacare for many years, like from day 1. Some object on the basis of “Government over reach”, namely the individual mandate. Other Republicans point to the increased, and largely hidden taxes necessary to subsidize ACA. And still other purists demand a return to a fully free market healthcare delivery system.
Thinking between the lines suggest these free market fans believe people are lazy and will not “work” hard enough to obtain healthcare on an open market. Bluntly people will sit on their butts if they think someone else will care for their needs. And in their minds, that behavior is not what made America great. Hmmm.
These views are close to the heart of why there is such a large divide in American’s feelings about healthcare. The heart of this debate, IMO, is whether one believes healthcare is a right or a privilege and whether every resident deserves the same basic healthcare with easy access or not.
If one accepts the principle of a right, there is still a wide range of methods to provide universal healthcare, and plenty of room for disagreement. But without a common view that in the richest country in the world, that healthcare is a basic right, there is little reason to expect broad acceptance of government healthcare policy.
In a world survey of modern industrial countries, the US falls way down the list, finishing well below two dozen other countries. Never the less Republicans claim “America has the best healthcare in the world”. What are they talking about?
Most likely these spokespersons are looking at leading US medical centers and basing their claim on the reputation of institutions such as the Mayo Clinic, the Cleveland Clinic, Johns Hopkins, or MD Andersen to name a few. These are world class medical organizations to be sure. The unstated clarification is that these institution and most other US medical centers are focused on getting a “sick” person “un-sick”. The US healthcare system is oriented towards fixing health, not preventing a person from getting sick in the first place.
Accordingly, such subjects as diet, preventive health steps, and exercise are treated almost as afterthoughts compared to heart by-passes, hip and knee replacements, or diabetes treatments. Oh, and did I mention that US healthcare delivery, Obamacare or what preceded it, cost twice as much as two dozen other modern countries while delivering health outcomes not as good. Hmmm.
In other words, considering what Americans overall pay for healthcare, the “replace” in “repeal and replace” should include increased coverage at lower total cost, especially if a business man is driving the bus.
So even if one does not see healthcare as a right, one has to wonder why anyone could think paying twice as much as other countries for less makes sense.