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BLOG: Health care law – the next generation
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This month will mark the beginning of a new era in American health care. The new Republican president has pledged to repeal and replace the Affordable Care Act as soon as he takes office.
Backed by a Republican Senate and a Republican House of Representatives, this seems like a fait accompli. The repeal part is easy; it is the replacement part that may present a real challenge.
This became even more complex this week with the recent “dust up” between the incoming president and the former governor of California, Arnold Schwarzenegger, over their respective popularity as a television game show host. Given the timing and the weight attached to the tweets of the president-elect, his remarks are very telling about his concern over his popularity with the American people.
According to the Department of Health and Human Services, 20 million Americans now have health care insurance under the Affordable Care Act. Unless the new replacement law can provide a comparable plan for these people, the new president is sure to take a dip in his popularity.
The fundamental issue that needs to be considered in debating this question is whether health care is a “right” or a “privilege” in our American society. In countries where it is considered a right and exercised within a “single payor” system, their citizens are in measurably better health. According to the World Health Organization (WHO) ranking of the world health care systems, the U.S. ranks 37th of WHO’s 190 member counties and 11th in the list of the 11 most developed countries.
The Affordable Care Act was an attempt to develop a hybrid system that used the traditional American health insurance industry and the government. If we are declaring that the hybrid has failed, do we go back to the unregulated insurance model of the last century or a government sponsored single payor system?
Americans love the single payor Medicare system for the elderly, and it is well established. Of course, the countries at the top of the WHO’s list of the most healthy nations all have some form of government-sponsored single payor system. But a single payor system is the champion of the ultra left of American politics. This was the hallmark of the Bernie Sander’s campaign. But yet Bernie and some of his ideas were very popular, especially among the young. Could we see our new president champion the single payor system? If so, could he get this by a Republican Congress? We are in for an interesting adventure over the next few years.
So, what do we as optometric health care providers want in a new system? I believe that one needs to separate their personal thoughts, goals and life plans from what is best for our society. It is also important to consider your thoughts about health care as a provider as well as from the perspective a health care consumer.
I believe that one should conduct their personal and business life from a conservative perspective. Make the most of your personal resources, strive for excellence and be ready to compete to be the best. Yet I also believe that not everyone in our society is able to compete. They do not have access to the same resources and often cannot even get to the bottom rung on the ladder of life in America.
With the advent of robotics and computers and access to a world economy, most of the job opportunities in manufacturing and labor have vanished from the American landscape. We have pushed many of our young people into a college education beyond their competence and created a broad acceptance of mediocrity. This has led to a large workforce of people that are unemployable in their area of education and training. We could spend lots of time considering how to solve this problem but, germane to this conversation, how do we provide health care for these people, and who should pay for it?
As optometrists, we have a huge stake in the future of the health care system in America. We spent the last century moving away from the product-based, merchant-based eyeglass business into an essential primary care health profession. We need to read and understand the evolving political conversation and participate in the conversation through forums such as this blog and other media. Meet with your elected representatives, voice your ideas and, most importantly, get involved with your state optometric association and the American Optometric Association. Your thoughts and opinions matter and can make a difference. Let your voice be heard.
References:
HHS. 20 million people have gained health insurance coverage because of the Affordable Care Act, new estimates show. Posted March 3, 2016. Accessed Jan. 10, 2016.
World Health Organization. The world health report 2000 - Health systems: improving performance. Posted June 21, 2000. Accessed Jan. 10, 2016.