One-size-fits-all health care is wrong
As the 2020 election season approaches, the U.S. health care system once again finds itself in the middle of a partisan debate. Some Democratic candidates for president have already unveiled their plans to fundamentally reshape the current system, while some Republicans in Congress renew their call to repeal and replace the Affordable Care Act.
Each of the partisan solutions, aimed at fixing the current state of our health care system, comes with its own set of critical questions that need careful consideration. For those in favor of “repeal and replace” is it better to destroy the current structure and rebuild, or are there elements of the ACA that can be salvaged? For public option advocates, should that be the default health care system for everyone, or used as more of a safety net? There is also the challenge of lowering health care costs while helping more people gain access to the quality, comprehensive coverage they need.
We believe the answer is not to drastically overhaul our entire health care system but to build, in a true bi-partisan fashion, on the successes we have seen under the ACA through practical, achievable and incremental reforms focused on lowering costs and expanding access and coverage to more Americans.
Several options to achieve access to coverage already exist. Expanding Medicaid guarantees coverage for under-represented and under-served populations. Offering more generous federal subsidies would allow more people to purchase the level of coverage they need. We should also prioritize consumer education around enrollment periods. This component is a highly useful tool that has already helped thousands of previously uninsured Americans make an informed decision about their health care needs.
Whether it’s known as “Medicare for all”, single-payer, or the public option, what are the perils of dismantling the existing structures and moving directly to a government-run plan? Under such a system, providers may see reimbursement rates drop drastically, which could ultimately undermine their ability to deliver high-quality services. Particularly for rural hospitals and health care centers, a public option — among the more “moderate” proposals by Democratic presidential candidates — would have dire consequences,
According to a recent analysis from Navigant Consulting and the Partnership for America’s Health Care Future, 55 percent of rural hospitals — more than 1,000 locations across 46 states — would be affected by a move to a governmentrun system. While the result of changes to their existing funding model are largely unknown, the impact of having reimbursements slashed could force many facilities to close or downgrade services and lay off much-needed staff just to stay open. It would also reduce a patient’s access to affordable, convenient options, forcing them to travel further and pay more for a lower quality of care.
Rising healthcare costs have been inappropriately attributed to physician and health care provider reimbursement and salaries, but as Bureau of Labor statistics indicate, most expenditures in our current health care systems have been related to administrative costs, which have continued to increase.
A one-size-fits-all government insurance system may also fail to address our No. 1 challenge — rising health care costs. So, the true question is how to avoid higher costs through increased taxes and private plan premiums, longer wait times, diminished access to care, and a lower quality of care for all Americans. By removing all ACA structures, there is a worry that private plans will ultimately struggle to compete with any government-run insurance system, causing loss of coverage and destabilization of existing structures. In a worst-case scenario, coverage options would continue to dwindle until there is nothing left but the government-run plan.
These changes could be especially detrimental to Americans living with mental illness or any chronic condition. . In the present structure, private and employer-sponsored insurance already offer preventive services that help improve health.
In summary, we recognize that catchall terms certainly work to energize the bases of political candidates, but they ignore the real issues facing our health care system, and do not offer a full solution. Ultimately, we are all in this together, regardless of our political stripes, as this affects not just our health, but our future generation’s health as well. That means in order to improve health care, we must all work together to strengthen the positive outcomes ACA has already brought. This will help ensure that we have a health care system that works for every man, woman, and child in America.