We have had problems with the rising costs of healthcare in our country since 1960. It seems no matter what we try to do, these costs continue to rise. Then in 2010, we had the passage of the “Affordable Care Act” or the ACA (Obamacare). While this law enabled millions of uninsured people to have health insurance, it did not stem the high costs of healthcare as they continued to rise. Here it is eight years later and we are still facing the same problems we have had all these years. There is continued debate, anxiety and concern by most of us about the state of healthcare in our country and there seems to be no consensus of what to do about it. Here are some of the most recent business transactions and healthcare law proposals/changes.
CVS, the large pharmaceutical company is going to buy Aetna Health Insurance Company.
United Healthcare Group is going to buy about three hundred healthcare clinics from Da Vita Medical.
Hospitals are morphing into large health insurance plans and health insurance companies are getting into the hospital business.
Amazon, Berkshire Hathaway Group and J. P. Morgan are going to form an independent company to try and rein in healthcare costs for their employees.
Amazon is now entering the medical supply business.
Speaker Ryan spoke of getting back to dealing with entitlement reform in 2018 which could mean looking at changes in Medicare and Medicaid
In 2017, the state of California tried to pass a single payer system for everyone who lives in the state including the three million uninsured. It eventually lost traction because it would have required to raise taxes and it was tabled for the time being.
In 2017, we saw Congress successfully pass the tax reform bill which will end the unpopular mandate forcing people to buy insurance which will take effect in 2019 and is predicted to have a negative impact on the future of the ACA.
In January of 2018, the state of Idaho’s Governor C.L. “Butch” Otter signed an executive order that called for his state insurance department to allow insurance policy options that did not include some of the regulations required by the ACA. Blue Cross of Idaho is set to offer several plans that do just that. This is thought to be another step in undermining the ACA. While this is technically against the current healthcare law (the ACA), it remains to be seen if the Trump administration will allow it to move forward. There are reportedly several states waiting to follow in Idaho’s footsteps if it is successful in this endeavor.
The states of Arkansas, Indiana, and Kentucky have instituted changes in their Medicaid programs that will require healthy adults to work or be in job training programs to continue to get Medicaid benefits.
In October 2017, an executive order was signed by President Trump that expended the association health plans or the AHPs and also offered short-term insurance plans which would not have to include some of the essential health benefits such as maternity care, prescription drugs and mental health services. These plans are less expensive and help many people who felt priced out of the ACA’s one-size-fits-all plans. Now Senator John Barrasso (R-WY) has introduced a bill this past Wednesday called “Improving Choices in Health Care Coverage Act” (S.2507) that would make these short-term health insurance plans permanent.
All of these changes demonstrate to me that what we currently have is still not working and we keep trying things that we hope or think might actually work. Trying to fix something that is broken is a good idea but what frustrates me is we keep focusing on making recommendations, business deals, changes and/or regulations to the different entities that are part of the healthcare industry which I call the providers. So after almost six decades now of going in this direction and still being faced with the same problems, you would think we might consider a different approach.
Here are some questions we need to think about. Before I list them, I want to make it perfectly clear that I believe all of us should and can have access to affordable, quality healthcare and that no one should be disqualified from getting health insurance because they have a pre-existing condition or conditions.
More and more people are getting sicker and sicker at younger and younger ages. How is this going to lead to less healthcare costs?
Many of these people have chronic diseases/conditions (such as: heart disease, strokes, diabetes, cancer and obesity) which accounts for at least 75% of healthcare costs? How will this lead to a reduction in healthcare costs?
All of these people will need more and more prescriptions, doctor visits, tests and procedures. How will this lead to less healthcare costs?
We already spend more than twice the average per year per person on healthcare (over $10,000 per person) than any of the other industrialized nations in the world and we are the unhealthiest of all. Why?
Our healthcare professionals are the best trained and best equipped in the world and yet we are the unhealthiest of the above referenced nations. Why?
It is time to accurately diagnose (the pun is intended) the cause of our healthcare crisis which is too much disease. It is time that the various groups that make up the providers of healthcare focus their knowledge, energy and resources on all of us (the providees). They need to educate, empower, support and incentivize all of us to make health a priority in our lives, to take primary responsibility for our health, to emphasize the importance of making healthier lifestyle choices and being more “proactive” about our health.
I know how to do this and have put forth a simple, uncomplicated plan to accomplish this in my new book Restoring “Health” To Healthcare.