Kevin R. Campbell, MD, FACC
Cardiologist and CEO, K-Roc Consulting LLC
In the last week, the Senate has failed to produce a viable bill to reform healthcare in the US. BOTH parties are to blame. The Democrats, led by Chuck Schumer have made it clear that they are focused on obstruction of ANY legislation. The Republicans, who own a majority in both houses, cannot seem to come to any consensus—infighting has crippled Republican leadership and severely limited their ability to pass any significant legislation. Sound bites are dominating the news with each side of the aisle pointing fingers at the other. Political posturing is consuming the time of our Congress and very little cooperation and progress is apparent. Democrats accuse the Republican majority of secrecy and a lack of transparency during the development of the healthcare bill—the exact same behavior exhibited by the Democratic majority during the creation of Obamacare more than eight years ago. All of the men and women in Congress were elected to do a job—unfortunately, most are spending more time championing individual causes and playing to cameras than they are actually working to negotiate solutions to legislative problems. As we celebrate the 4th of July holiday this week, I expect better from those who are elected to represent the people of this great country.
The Current Issues:
- Obamacare is no longer viable. While the ACA legislation does insure large numbers of Americans on paper, the reality is that many of the newly insured have been left with minimal access, high costs (that continue to rise) and very limited choice. If Congress chooses to do nothing, it is likely that more insurers will abandon the exchanges and leave even more Americans will be left without any insurance choices—AND, under current law, be fined for not having insurance (even though there may be nowhere to purchase a plan). Moreover, the uncertainty in the insurance market has resulted not only in a mass exodus of insurers but has also driven up premiums to levels that prohibit many from affording anything more than “catastrophic” type plans with high deductibles and minimal coverage. There is no focus on preventative care and many Americans continue to go without any care at all.
- The current Republican proposal in the Senate does some—but not nearly enough– to fix the problems with the ACA. While the Senate bill does eliminate the individual mandate and many of the taxes associated with Obamacare, it does not address many of the core issues that both doctors and patients consider vital to any meaningful reform. For instance, there is nothing that addresses the rising prices of pharmaceuticals (and price gouging by pharma CEOs). Americans pay more than any other country in the world for drugs—Why can’t Medicare negotiate prices with pharma? In addition, there is no provision to allow for the purchase of drugs from foreign pharmacies such as those in Canada. Allowing foreign competition will certainly lead to lower prices within the US. Additionally, the plan does little to limit insurance costs—we were promised legislation that would provide for free competition among insurance companies across state lines—in order to allow free market forces to lower prices and improve services. This has not occurred and is not part of any Republican proposal in the Senate. Most significantly, there is no attempt to address tort reform in order to lower healthcare costs. Doctors continue to drive costs by ordering unnecessary tests in order to avoid frivolous litigation by trial lawyers.
My “4th of July” Take
It is clear that neither Democrats nor Republicans are ready to come to the table to work together towards meaningful reform. The President has offered little leadership of substance in the healthcare debate other than making vague statements such as “we are going to get this [healthcare] deal done and its going to be great”. Both sides are to blame for the rising cost of insurance and the runaway prices of pharmaceuticals. While the Democrats are unified on a plan of ‘legislative resistance’, Republicans continue to bicker about whether or not the healthcare bill is ‘too moderate’ or too conservative’. At this point, I do not believe the Republican proposal goes far enough to fix the pending healthcare crisis in our country today. Ultimately, doctors want to be able to take care of patients without government interference and patients want the freedom to choose their healthcare and purchase an affordable insurance plan that best meets their individual needs. We must get Congress to act—we need transparency in healthcare pricing and we need to hold both pharma and insurers accountable. We must also hold lawmakers accountable in November—either get the job done, or get out. America can no longer tolerate the status quo in Washington. The 4th of July symbolizes our right as Americans to determine our own destiny. Remember, the election of 2016 was all about disruption and a rejection of business as usual—Wake Up Congress, you have been put on notice. Fix healthcare or the voters will once again speak loudly during the next election cycle.