HEALTH CARE

Obamacare has provided higher quality health care for more Americans at a more affordable price than existed before Obamacare, and has done it preserving a well regulated capitalist healthcare system. It is a work in progress and needs tweaking (not repeal and/or replacement with inferior quality Trumpcare) to make it even better.

To provide high quality equitably distributed health care it needs to keep:

1.    Mandated health insurance for everyone. Taking away the mandate will cripple American health insurance. If healthy young people are not included, the pool will be weighted with expensive sick people. That’s how insurance works. You pay into it even when you don’t need it so that you have it when you do need it.

2.    Acceptance even with pre-existing conditions. The mandate will ultimately even this out.

 It needs to add:

1.    A public option. This will add to competition (a capitalist concept). It will also fill gaps where a suitable private option is not available (like some sparsely populated rural areas).

2.    Promote efficient health care delivery systems to keep down costs. For example, in the Kaiser model, the insurance company and medical group negotiate the plan every year. Medical group has responsibility to provide quality care. Insurance company has responsibility to provide the money. Together they negotiate value.

3.    Control drug prices. It should be illegal to advertise prescription drugs to the public. That adds unnecessary expense and promotes drugs based on popularity rather than effectiveness, efficiency, and necessity.

4.    It is known that non-profit health care plans provide the best care for the price, probably because they don’t have investors skimming off the top. Perhaps the market will eventually eliminate for profit plans.

A single payer system is not necessarily the best way to go. But as things progress, if it becomes apparent that it is the best way to go, then so be it. All things being even, a well regulated capitalist system is probably the best.

Trumpcare and lack of regulation promotes fly by night, quick buck, in and out plans that keep quality down in order to keep prices competitive. Patients get caught when they need care that is not provided. Also, preventive care in high quality plans actually keeps costs down by keeping patients healthy. People with no or poor quality insurance end up with more expensive emergency room care that the community ends up paying for. Emergency rooms are set up and their staffs are trained to provide emergency care, not routine health care.