As I sit here contemplating the future of health care in America, my mind wanders back to the time I spent as a young doctor working in inner city hospitals taking care of the poor who were either uninsured or covered through Medicaid. I wish that more our Congressmen could have shared that experience witnessing first-hand what poverty and lack of health care do to people.
Certainly, the Affordable Care Act was a great boon to millions of Americans who gained health insurance, often for the first time. I admit it is an imperfect law, and its name is a misnomer. Ironically, while it provided access to health insurance for many, it did little to make health care more affordable. In 2015, the United States spent about $3.2 trillion on health care. If our health care system were a country, it would be the fifth largest in the world behind the U.S., China, Japan and Germany.(1) We have failed to attack the root cause of the problem. If health care weren’t so expensive, then health insurance would be readily affordable.
At the same time, many in Congress fear that if the bill is not repealed and health care spending sharply curtailed, the cost of health care will erode the federal budget, threatening the financial security of the nation. One quarter of the Federal budget is devoted health care, more than what we spend on Social Security or Defense.(2)
The ACA does not need to be “repealed and replaced.” Let’s not throw the baby out with the bathwater. Republicans have the tremendous opportunity to learn from the Affordable Care Act about what worked and what didn’t without the polarizing political rhetoric. Someone needs to reach across the aisle and have the courage to compromise to achieve our common goal. Will it be Speaker Ryan? Will it be Senator Schumer? Where is the “Mr. Smith” who will lead us forward to reform health care in a way that benefits all Americans?
(1)Emanuel EJ, JAMA 316:2604, 1996