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Affordable Care Act

Many Americans are quite upset about our healthcare system. We should be. Healthcare represents nearly 20% of our economy and it is a mess. There is a long list of problems, but, from my perspective, two things stand out as the most outrageous. First is the lack of healthcare reform and the high cost of delivery of healthcare in America. It is 50-100% more costly per person than other developed countries which have equal or better care. Second is our corrupt Congress which marches to the tune of special interest groups. Many people who have studied our healthcare system diligently, including me, have offered common sense solutions, but it seems political priorities supersede all solutions. Following  are the three things most upsetting at the moment.

 The Affordable Care Act (ACA) has many problems, but there are some good things in it. For example, focus on quality and patient safety, focus on patient satisfaction, and accountable care, which has the potential to greatly reduce the cost of healthcare delivery. The ACA also has things in it people don’t like including hidden taxes, mandates, and unaffordable premiums and deductibles. Our elected House of Representatives passed a new law. It goes too far on some things and not far enough on other things. What is upsetting is the Senate decided to completely ignore the effort of the House and start over again. An analogy in industry would be for Apple engineering to design a new product and then Apple marketing completely ignore the work, or vice versa. Zero teamwork, politics first, voters third, after the special interest groups. This is not a political statement. Republicans and Democrats are equally corrupt. 

 The Senate stacked the deck with a committee to develop a new healthcare law by including no moderate or centrist senators and no women. The latter is most shocking. Fast Company reported some relevant facts about women in healthcare.

  • Women comprise 80 percent of the U.S. healthcare workforce.
  • 21 percent of healthcare executives are women.
  • 90 percent of nurses are women.
  • Women visit physicians more frequently and ask more questions.
  • Roughly 80 percent of healthcare decisions in households are made by women.
  • Women are more likely to take care of family members when they get sick.

Should women play a key role in the development of a new healthcare law? Duh.

 Why are drug companies able to continuously raise the price of drugs?. “The simple answer is because there’s nothing stopping them,” says Leigh Purvis, director of health services research for the AARP Public Policy Institute. In 2015, I wrote about Medicare is the largest purchaser of drugs, and how Congress inserted a provision in the Prescription Drug Plan forbidding Medicare to negotiate the prices they pay. The top priority of senators is to get reelected. You can see the results as the average age of a serving senator increases. Second priority is to keep political lobbyists and donors happy. Somewhere further down the list comes addressing consumers going bankrupt from drug costs. Two Senators, a Democrat and a Republican, put a special provision in a tax bill which gave a benefit of $400 million to one drug company, Amgen, which donated to both of them.  Drug companies need to be profitable to support expensive research, but they should not be given a blank check to set Medicare drug prices. And, they should not spend billions on TV advertising of new high cost drugs, some of which are less effective than existing drugs. No other country allows it. How high is high enough profit? Operating profit margin of GE last year was 14.4%, for drugmaker Amgen, it was 42.6%. 

Epilogue: I ran into a family friend downtown today. He is 36, married, and has two small children. His monthly healthcare premium is approximately $1,000. His family deductible is $12,000. He has healthcare insurance, but it is not affordable. He likened it to having a second mortgage payment.

Read much more about American healthcare in Health Attitude: Unraveling and Solving the Complexities of Healthcare.

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