Published on Robert Pearl, M.D., Forbes Healthcare Contributor
Pain is a more powerful emotion than pleasure. Loss has a far greater impact on the human psyche than gain. For these reasons, the Republican plan to “repeal and replace” the Affordable Care Act (ACA) had to fail. And if our nation fails to reform the healthcare delivery system, as well, the impact will be even more painful.
Seven years ago, not long after the ACA became law, the GOP reassured supporters that repeal would happen—that for the good of the nation it had to happen. In drafting their replacement plan, legislators embraced healthcare spending reductions as a path to lower taxes. As a result, each of the healthcare bills introduced this term would cause tens of millions of Americans to lose their health coverage.
Congressional Republicans underestimated the pain this would cause. Now, they’re the ones feeling it. With healthcare reform efforts in limbo, President Trump resolved last week to “let ObamaCare fail,” later telling White House reporters, “I’m not going to own it. I can tell you, the Republicans are not going to own it.”
No one can say when or whether those on Capitol Hill will make another attempt at repealing or replacing the ACA. But one thing is for certain. Reform or no reform, pain is coming. And for politicians, pain always has an owner.
The Source Of Pain
Elected officials on both sides of the aisle recognize American healthcare today fails to deliver the quality and convenience patients deserve, especially given its $3 trillion annual price tag.
Healthcare today is dangerously expensive and inefficient, and will continue to be without radical change to the current system’s structure, financing and technology. For decades, these changes in care delivery have constituted the “third rail” of the debate, and few politicians have dared touch it. That’s because insurers, drug makers, national physician groups, hospitals and other institutional powers have openly, and effectively, lobbied against any legislation that would cause them financial harm.
This leaves the legislative process at an impasse. Unless care delivery is made more efficient, efforts to expand coverage, as Democrats desire, will demand higher taxes. And without delivery system reform, Republicans hoping to lower healthcare spending face the brutal reality that millions of people will lose coverage.
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