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AHCA – How to transform health care with bipartisan support

May 04, 2017
Kent Holtorf
From the May 2017 issue of HealthCare Business News magazine
Because of a lack of support, the American Health Care Act (AHCA) was withdrawn for a vote from Congress.

Additional modifications to amend the American Health Care Act were proposed to help appease conservatives and moderates who had concerns about the original bill. Additions included changes to Medicaid, giving states the option of requiring able-bodied Medicaid recipients to perform community service, participate in job training or work.

Also, states would have the option to receive a block grant for adults and children participating in Medicaid versus a set amount of money per enrollee, reducing federal support for Medicaid. The House has proposed earmarking $75 billion in additional tax credits for older Americans to help offset the cost of buying policies in the individual market. Ultimately, these changes are simply not enough to make the American Health Care Act a success because the fundamental challenges and basic reforms have still not been addressed.

However, even if it had passed in both houses and was signed into law by President Donald Trump, it would be still doomed to fail, like the Affordable Care Act. There is much disagreement about the latest attempt at health care reform and no consensus on how to structure a plan that will work for everyone long term. Health care reform’s only chance for success is by gaining bipartisan support, which means real, fundamental reform that would be able to provide universal coverage without dramatically increasing the national debt or taxes. The problem is that everyone is trying to figure out how to pay for dramatically overpriced goods and services while missing the key element that is preventing a lofty, but very attainable, goal of affordable universal coverage.

The current U.S. system is based upon an insurance model, which is designed to provide coverage for medical emergencies. Insurance is not designed to function effectively for routine care and has never worked in any industry as a method of providing services that are used on a routine basis. This is because it is excessively bureaucratic and the only method of controlling costs in an insurance-based model is by denial of coverage and using complex reimbursement formulas. In reality, the insurance companies’ end goal is not to reduce the cost of health care, but, rather, to increase it. Also, the end users (patients) and providers (doctors, hospitals and laboratories) have no incentive to control costs. They all want to get as much payment as possible. Is it not surprising that health care costs are spiraling out of control when all parties involved make more money if health care costs rise over time?

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