Healthcare Cost Unsustainable

People Don't Hate Obamacare, They Hate The Cost. Fix That GOP

As I anxiously watch the whip count on the American Health Care Act, I speculate what must go through the minds of the undecided Republicans. "We promised to repeal Obamacare. We have to repeal Obamacare. My constituents hate Obamacare." However, as they check back with their staff they find the calls overwhelmingly urge them not to pass the American Health Care Act.

Why the mixed message? Those of us in the field know the truth - it isn't Obamacare people hate, it is the complexity and the outrageous cost of the health care system. The American Health Care Act will address neither of these issues and most likely will make matters worse.

Do you notice the insurance companies are quiet like crickets? I stated on The Takeaway yesterday, "Insurance companies come out fine either way". We hear their tales of woe about losing money with the ACA based plans. What the press isn't sharing as loudly? Insurance companies are making record profits on all their other lines of health insurance - group insurance and Medicare supplements are a goldmine. Aetna just announced record profits last quarter and easily breezed past estimates. They plan to dump individual markets (ACA plans) to improve their numbers. With the AHCA, insurance companies will fare just as well and have more power to cherry pick the best patients through pricing controls based on health factors.

Yes, the Republicans promised to repeal Obamacare. But the Republican President promised to replace it with something much better that would cover everyone. The public recognizes the disingenuous attempt when Republicans say they will make insurance available for all and they don't advertise that the premiums for people with pre-existing conditions will be off the chart. And what most people don't realize? Even people with minor pre-existing conditions such as high blood pressure, diabetes, and asthma will have significantly higher premiums.

To make matters more real for the public and more painful for the Republican health plan, Jimmy Kimmel shared his tearful story of his son who was born last week with a heart defect and deftly points out that pre-Obamacare, his son would be uninsurable because of a pre-existing condition. Fortunately, Kimmel's son will have the resources to purchase very expensive coverage through the new Trumpcare plan, but most people aren't as fortunate. We must do better.

I recently experienced first hand an example of practices they could tackle. Being a doctor, I occasionally discuss "gross" medical issues, so this is a warning to skip this paragraph if you don't like reading medical topics. I recently received a bill from my gynecologist for a physical.

In addition to the $256 charge for my physical, there was a $48 charge for "colorectal screening". Being a doctor, I recognized that she did not do colorectal screening - she did a rectal exam that should be part of the physical. A rectal exam is no longer considered colorectal screening, plus she knew I had my screening colonoscopy two years prior so I don't need screening. But there it was, that $48 charge on my bill that my insurance company paid. I calculated that if doctors charge for colorectal screening for all women over 50, we are spending $2.5 BILLION extra per year on unnecessary rectal exams. What a waste! This seems minor, but these little charges add up.

Republicans can turn this ship around. The first step is admitting the American Health Care Act will not take care of people the way they want and need, and especially the way President Trump promised. They can then step back and start work on the real issue - the cost of health care. Fixing the fee for service system, our crazy billing practices, the crushing bureaucracy faced by patients and doctors, waste in the system, unnecessary care, and egregious pricing practices of the pharmaceutical companies will go a long way toward restoring public hope. Look outside the tired mantra of "free market" or "single payer" - fund primary care cheaply for everyone through appropriate funding of community health and the prevention and public health fund. Reducing the cost of care will result in lower premium prices which is what we all want.

The whip count on the Hill continues today. Call your congressional representative to share your thoughts. It is easy to do, and hopefully we can get them to park the Titanic and start over.

https://libertyinvestor.com/people-dont-hate-obamacare-they-hate-the-cost-fix-that-gop/