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Health Care Reform – A Story of Increasing Dissonance

It should come as no surprise to you that I’m still talking about healthcare.

Since my last blog post, health care reform in the US has been up for discussion 3 times within Congress. Each time, the proposed bills have increasingly targeted reducing health care coverage for individuals while simultaneously reducing federal spending and cutting taxes for the wealthy.

I do not like these bills for a number of reasons.

1. The bills were designed to cut federal costs, but, are short-sighted.

It was estimated to reduce the federal deficit by ~130 billion dollars and would have reduced premiums by allowing insurance companies to reduce coverage for the ’10 essential benefits’ of healthcare.

While that sounds good to some initially [less money spent and lower insurance costs] the problem is that this would force states to reduce the amount of people covered and the amount of coverage they would receive by reducing Medicaid enrollment and coverage. It would have also created the avenue for individuals to buy cheaper insurance at higher price/benefit ratios.

However, if this bill had passed, it likely would have resulted in higher GDP health care costs as patients present in more advanced states of disease and are then forced to pay higher costs and are more likely to be disabled.

2. They were not designed with the goal of keeping people healthy

In an age where we know that social determinants like housing, education, jobs and income affect health and outcomes, as health care providers, we cannot allow for healthcare reform that serves to isolate the vulnerable further. It would discourage people from seeking healthcare by choosing cheaper healthcare plans or choosing to become uninsured. Overall, regardless of health insurance, people would likely be forced to pay higher out-of-pocket costs as costs shift from the federal government and private insurance companies towards the state and trickled down to the individual patient.

Put simply, we want to see our patients and treat their hypertension and diabetes now, not wait 10 years until they present to an emergency room with a heart attack that could have been prevented. These bills had no intention of keeping people healthy or improving their chances of doing so.

3. They are politically charged and partisan

Healthcare should not be a partisan issue. However, it still remains a politically charged debate that confuses most individuals.

It seems like the current majority is insistent on repealing the Affordable Care Act [ACA] for the simple reason that they did not approve of it in the first place. Now that the bills did not pass, it appears that they are content with allowing for the ACA to continue to suffer and are actively reducing funding for enrollment.

This is despite most medical associations advocating against the repeal of the ACA when the most recent conservative bills were up for vote in Congress. Most individuals who truly care about improving health care in the US would agree that we need to improve health care access in the US, not strip it away. However, it appears that none of that matters in the eyes of the current administration, who do not seem to consider basic health care to be a human right.

Thankfully, the bills did not pass. However, it is important to know that a large amount of Senate and House representatives voted to pass a bill that would harm millions of Americans for the sake of saving face and reducing short-term costs. In fact, a majority of republicans who voted for the bill wanted for it to be more conservative and take away more healthcare benefits. The current administration does not seem to be concerned about health care outcomes, rather, they are focused on health care costs and achieving partisan victories. This is in sharp contrast to what most health care advocates and professionals believe is important to improve health care outcomes in the US.

What worries me is that most of America seems unaware or indifferent as to how dangerously close they were to being affected. Ultimately, medical groups advocating against these bills seemed to play no major role in whether or not the bills were allowed to pass. We need to do a better job of enabling our communities to advocate for their own health care rights and needs. This can only happen by enabling an open conversation on understanding health care and improving it through grass-roots organizing and community engagement.

I’m not sure what the future of health care in the US should look like. There is a lot of talk on Medicare for All currently [with pros and cons]. There is also talk of allowing the ACA to ‘implode’ and then switch to block grants [which will be disastrous for health care outcomes in my opinion]

Personally, I think that we should have an opt-out government negotiated/subsidized plan with essential benefits while maintaining private insurance options for coverage needed beyond that.

Whatever happens though, I think the public needs to be better informed and engaged and we need to work on making that happen.

If you’re interested in organizing towards the right to healthcare, please join some of my colleagues who are interested in advocating for a single payer health care system in Massachusetts]

Till next time,

Yuvaram

P.S: As usual, the above opinions are entirely my own, and, do not reflect upon the other authors of this blog, or, of Boston Medical Center.

This entry was posted in BMC.

One comment on “Health Care Reform – A Story of Increasing Dissonance

  1. A good reminder that local health is global health, and that we as doctors need to be involved in the ongoing debates around healthcare in the US, Yuvaram.

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