Health care: What is the solution?
The Affordable Health Care Law (Obamacare) is self-destructing. The new plan presented by the Republicans can’t get enough votes to pass the Senate. It’s a mess.
We have had four major efforts to deal with health care in the history of the United States. These include the creation of Social Security in 1936, Medicare and Medicaid in 1966, President Ronald Reagan’s IMPALA law in 1986, and President Barack Obama’s Affordable Health Care Law.
Reagan’s IMPALA law was simple and easy to understand. It required hospitals to provide medical care for those who could not pay for it. It wasn’t long until the bill for indigent care at most hospital exceeded 25 percent of the total budget, an impossible burden for local hospitals. Hospital leadership in the country called the situation untenable. Many smaller hospitals across the country closed. The American Hospital Association became a major support group for the passage of The Affordable Health Care Law, not necessarily because they liked it but because they needed to get out from under the burden of IMPALA.
Social Security and Medicare both were passed by Congress and then given an 18-month waiting period before becoming completely operational. The plan was to pass the measures as philosophy/concept and then for the health care industry and others directly involved to provide input and “hone” them into workable programs for the long term. Social Security has now been in force for 81 years and Medicare for more than 50. Neither is without their critics but, for the most part, both plans have worked to the benefit of the country.
What was true of Social Security and Medicare was planned for the Affordable Health Care Law. It was passed with some detail but, primarily, as philosophy/concept and then set up to have 18 months to work on the details. Unfortunately, one political party refused to work on the new law saying from the beginning that it should be repealed. Thus, unlike the Social Security and Medicare laws, it had very little done to it in the 18 month “dead” period prior to its full enactment in 2014.
It is good to remember what the AHC plan was designed to accomplish. At the time we had more than 40 million people in the country without health care insurance. The AHC was designed to get everyone under some kind of coverage.
Another negative is the fact that currently we have more than 180 million Americans on employer-provided health insurance. Explaining how health care became attached to business and industry would require us to retrace history to the days following WWII, an exercise for another time. Suffice it to say that because of such fringe benefits for U.S. workers, American business is at a major disadvantage attempting to compete in the world marketplace with businesses from countries that have government provided health care. Our international balance of payments, (sales versus purchases) has been negative since 1976. Count the number of foreign cars on our highways for proof.
Our health care system, actually a non-system, has been problematic for years. It grew to its present state with little united planning and virtually no comprehensive leadership.
How should we solve this problem? First, we need our best and brightest to work together to solve the nation’s health care problem. Then, as is true in any planning model, we need to focus on “what”: What we want, what will work, what will best meet the needs of our people. Finally, we need comprehensive planning to create an approach that takes us from where we are to where we need to be.
We need a national commission to bring our health care professionals to one table with a mandate to give us what is needed to solve our dilemma. Can it be solved? Of course it can. Many other countries solved it years ago. Will everyone be happy with the outcome? Dream on.