The American Health Care Act Doesn't Sound Very American to Me

The American Health Care Act Doesn’t Sound Very American to Me

The GOP’s recently proposed American Health Care Act (AHCA) doesn’t sound very American to me. I don’t see how a plan that is reported to likely see 14 million Americans lose their health care coverage in one year and 26 million by decade’s end as being very American. I don’t see a plan that gives tax credits to the wealthy and removes caps on insurance company CEO bonuses as being very American. I don’t see a plan that burdens lower income, particularly seniors, with higher premiums and out-of-pocket costs as being very American. 

What would be a truly American health care plan?

I will just come out and say it, a single-payer plan that covers one and all. That would be it. Yes, universal health care. I’m for that. It boils down to the philosophical belief held by many, including me, health care is a right. Period. It is not a privilege based on one’s ability to pay.

Don’t like the idea of universal health care?

Then why not try to fix the Affordable Care Act?

Why not try that first?

Isn’t this just logical?

I’m still trying to figure out why there is such a rush to repeal and replace the Affordable Care Act (ACA). Why not fix the problematic parts or at least consider this. If things cannot be fixed, go from there. But shouldn’t a repair at least be considered?

After all, parts of the ACA are generally well liked because they will be kept, so is it truly be repealed anyway?

I realize I sound like a typical liberal Democrat, but even if I were a Republican, I would still be in favor of universal health care for all. (Does such a Republican exist?) Because again, I would still believe that health care is a basic right in a country such as ours.

Our system is so messed up at this point it can seem like the solutions are ambiguous at best and downright impossible at worst.

Sometimes we make things too complicated.

Again, it boils down to, do you believe anyone and everyone living in the USA in the year 2017 and beyond deserves health care, or don’t you?

Does your best friend deserve health care? Does your former work colleague who got fired three months ago and is still job searching deserve it? Does your elderly relative deserve it? Does your disabled cousin deserve it? Does your unemployed neighbor and his four kids deserve it? Does the single mom working herself ragged trying to make ends meet deserve it? Or the single dad? Or the part-time worker trying to get by on minimum wage?

Do you deserve it?

And if you do, why would anyone else not?

Yes, there are issues with the ACA. For example, the insurance companies are pulling out of the exchanges because they say profits aren’t there; they are losing money. But how and why are insurance company CEO bonuses still so high then? Something’s off here, don’t you think?

There is the valid concern that if we were to go to a single-payer plan, what would happen to the insurance industry? And the pharmaceutical industry? Well, the insurance companies would need to adapt. The drug companies might need to as well. They’ve had too much control for too long anyway.

It’s better to put the American people (all of them) first, is it not?

Isn’t this what President Trump promised?

And yes health care is expensive. Priorities will need shuffling. But does anyone really believe costs are going to come down anytime soon when our present system is a for-profit system?

I don’t have the answers. There are many people a lot smarter than me who could figure this stuff out.

The United Kingdom it seems has a pretty good thing going as far as their National Health Service (NHS) goes. Everyone kicks in a determined amount based on income. Everyone receives quality care. And the UK spends less on health care than the US does. In the UK, private insurance is available, too, offering another layer of coverage. So there’s that option to mull over.

The same is true about Canada. Less money spent. Better outcomes. And overall, Canadians like their system.

Americans like to think we have the best health care in the world, but the facts supporting this belief don’t stack up.

Of course, there would be problems with universal health care, too, big problems.

But don’t we have big problems now?

Supporters of AHCA such as Paul Ryan proclaim their new plan offers Americans freedom to buy what you want to fit what you need. This logic isn’t reality for many. It you can’t afford what you need, it’s not freedom. Fake freedom in health care (or anywhere else) is not freedom. And waiting to buy more coverage until you’re older (and likely sicker) makes no sense, fiscally speaking.

The goal should always be to cover more people not fewer people because sooner or later everyone needs health care.

Can you imagine, walking into your clinic and not having to worry about insurance this and insurance that? No co-payments. No deductibles. No quibbling about coverage. No fights over the phone with your insurance carrier rep trying to convince him/her that you need a procedure your doctor recommended covered.

You get sick. You go to the doctor. You get care. You go home and try to get better.

Call me naïve. Call me idealistic. Call me crazy. Call me whatever you want. I don’t care.

At some point, the US will likely end up going this route of universal health care for all, anyway. Because not doing so isn’t working. It’s coming, though getting there will undoubtedly be a long, painful and highly contentious process.

Maybe it’s time to start figuring out we go about implementing such a “radical” idea.

Until then, it makes no sense to repeal the ACA.

Finally…

Until every American has (not has access to, but has) health care, no plan should be called an American plan.

Do you believe quality health care is a basic right for all Americans? Why or why not?

If you live outside the US and your government provides health care to all, how’s that working for you and your family? What are the biggest issues?

Do you believe the US will eventually offer universal health care for all?

Sign up for news/emails from Nancy’s Point!

Featured photo:  Eric Thayer/Reuters

Flag image via Wikimedia Commons

NOTE:  The Republicans are trying to amend the AHCA proposal in order to increase its chance of passing in the House.

 

Do you believe healthcare is a right or a privilege?
Until every American has health care, no plan should be called an American plan.

 

17 thoughts on “The American Health Care Act Doesn’t Sound Very American to Me

  1. Hi Nancy,
    I do believe that health care is a basic human right. But sadly, I do not think we are likely to see universal health care in this country. I lived In Canada from 1990 -1995. Their system (single payer) is set up to make care more affordable and regulated. For example, everyone sees a GP- a general practitioner. Pediatrics, obgyn and internal medicine are considered specialties. Because people can see a doctor without paying steep co-pays or deductibles, preventative care is affordable. Treatments such as message are covered when recommended by a doctor, such as mine were when I was pregnant. Taxes are higher. I could certainly live with that. Universal health care as practiced in Canada is socialized medicine, which is fine by me. But in the good ole’ USA, socialism and taxes are dirty words. And Congress takes advantage of that sentiment.

    1. Joyce, I actually think we might see it in the US. The ACA started moving us in that direction. Your last two sentences say a lot. Thank you for sharing.

  2. Oh, Nancy this is a hot button issue for me. I work on the front line in a medical office so I see day after day what health insurance has become for doctors and for patients. I do believe health care is a right and access should be for all. I have the difficult conversation so many times to tell a patient that the doctor I work for is not in their network and what will be required for them to access their insurance benefits. I want to be able to say “yes” to everyone that calls our office asking for help but instead I am in the awful position of trying to explain why their insurance is not accepted. I cannot even think how we would have treated my cancer without insurance. The issues are deep in the U.S. Choice is the idol that we worship and that choice is not even really equitable. Where else in your life do you not have the opportunity to comparison shop for something so important? It is a shell game and insurers are only too happy to keep everyone guessing. For example when I went into get my first mammogram after breast cancer not one person told me that this was not going to be covered by my insurance. I did not even think to ask because it had always been covered before. Ah. . .but the trick here is now I have “evidence of disease” so no longer is it considered a preventative procedure. I understand, that even makes sense, but why are price and fees never discussed unless you specifically ask. The trick is knowing what to ask. How would you know? The patient is held captive because of course you are going to get that follow up mammogram. It would have been courteous to inform the patient that there may be costs involved. I think the truth about costs need to always be discussed but doctors are not trained to discuss the monetary aspects of their business. It’s all about caring and providing the best care and cost is secondary but that is not the reality for many Americans. It’s not that families do not want to provide the correct care for their families but they need to be able to make informed choices and have the opportunity to really explore what health procedures are necessary and where the value is. When I went in for follow up with my radiation oncologist I was billed an additional $100 for a hospital visit. When I questioned it, I was told that because my doctor’s office was located inside a hospital they were allowed to collect a fee for “visiting the hospital”. Really? Let’s see where else would you find radiation equipment for treating cancer except at a hospital? As a person who is tasked with helping patients navigate their care and insurance I see too often how this ridiculous form of payment creates difficulty for patients and doctors alike. So often payment is arbitrary and prolonged for vague and unclear reasons. Insurers change their policies at the drop of a hat. One day your medication is covered and the next time you are standing at the pharmacy and they tell you pre-authorization is required. No advance warning and there you are without your meds for sometimes a day or two but sometimes even longer than that. Doctors are left to scramble their way through this maze of regulations and arbitrary policy changes so even their office staff cannot properly inform their patients. I do believe Universal Health Care has its limitations too but as compared to the present day situation where it is not equal for everyone it seems appealing. Charges for patients are not even equal and that is the real secret because the consumer doesn’t know what they are being charged and what they are paying for. I could go on and on. I do not have specific solutions but I do believe costs need to be more transparent if consumers are going to have real “choice” in such important decisions.

    1. Sandy, No wonder this is a hot-button issue for you! You have a difficult job, for sure. The insurance companies have had way too much control for way too long. One thing I keep wondering about is why they are allowed to simply pull out of the exchanges and stop offering coverage. They claim they aren’t making money, but I don’t buy that when you hear about the big CEO bonuses and such. I totally agree, they are more than happy to keep everyone guessing about costs. And a $100 “visiting the hospital” fee? Wow. I believe we are slowly and painfully making our way toward single-payer or universal health care in the US. Time will tell. Thank you for sharing your valuable insights.

  3. Health care in Canada is not Universal, all provinces have their own plans, eg. in British Columbia basic coverage is $75.00 for one person, $136.00 for two.
    I live in Manitoba, every permanent residident receives basic coverage at no charge.
    Services include Physician services that are medically required.
    Surgery and anaesthesia. X-ray and laboratory services when ordered by a physician and done in an approved facility. One routine eye exam by an optometrist every 2 years for residents under 19 or over 65 years old. Eye exams that are considered medically necessary by a physician or optometrist are covered regardless of age.
    Manitoba Cancer Care asked the government to cover cancer drugs and they agreed, not sure what is all on the list but I pay nothing for my Letrozole. I was shocked to read Sandy had to pay for her mammogram and an oncologist visit, there is no charge for cancer treatments or followups here.
    We do buy extended medical which costs us $105.00 a month through the company my husband worked for. It covers 80 percent for prescriptions and a great deal more basic coverage doesn’t give us.
    Our system is not perfect, the worst thing about it is that wait times can be long unless your problem is life threatening, then of course you get quick service. I needed cataract surgery, the government has a cap on how many cataract surgeries can be performed in a year, my wait time was 13 months for one eye and 19 months for the other eye. A friend in the U.S. had cataract surgery, both eyes were completed in three months. ( My husband said if we knew you could get it that fast there he would have gladly paid the price.) There are also caps on many other surgeries, hip and knee replacements are a couple of examples.
    Our system, as I said before is not perfect but it is affordable for everyone no matter what province you live in. Manitoba has higher taxes than most other provinces, everybody shares the burden when it comes to health care but rich or poor everybody is covered and we like it that way.

    1. Laura, Obviously, I do not live in Canada, but I believe it is considered to offer universal health care. Perhaps things vary somewhat from province to province. It sounds like you have the option of extended coverage, too, like the UK does. There is no perfect system. When you think about it, how could there be? We are talking about people, illness, medicine and dollars – all complex things on their own. Your last sentence says it all. The whole point is for everyone, the rich and the poor to be cared for. Thank you for sharing.

  4. I’d just like to clarify something that Laura mentioned. Health care in Canada IS universal. Under our federal health care act called medicare, all citizens MUST be covered regardless of medical history or financial ability. The provincial and territorial governments are responsible for the management, organization and delivery of health care services for their residents and some provinces are better than others in that department so there are some differences in wait times etc. But the bottom line is that everybody has access to good medical care. If you want you can buy extra insurance called “extended care”, and as Laura mentioned, it will pay for extra things like massage therapy, medications, etc. Many people get this as a benefit through work, but if not you can pay for it privately and it is not that expensive in the long run. The way it works here (and I’ve had the same experiences in two different provinces), your family doctor refers you for your mammography, the mammography doctors refer you for your biopsy with a surgeon, the surgeon refers you to the oncologist/cancer clinic, and from there you are referred to specialists, support groups, etc. I might add that cases are triaged so the most urgent cases jump to the front of the line. This is why you often hear people complain that there are long wait times. It’s usually because hip replacements, cataract surgery, etc are considered elective surgery. All of my appointments were made for me and all I had to do was show up. At the cancer clinic I even had a social worker assigned to me to answer any questions I had about claiming disability or dealing with work issues. My care was exceptional and I really don’t know how I would have managed if I’d had to worry about affordability or trying to navigate the complicated system that Americans have. I simply don’t understand how one of the wealthiest countries in the world can deny standard health care to its citizens. Will it raise your taxes? Maybe. But isn’t it worth it to know that your sister’s daughter, who is a single mom and unemployed, is going to get a chance at life? I’m not sure if Americans will ever come to terms with this problem and I agree with Joyce about taxes and “socialism” being dirty words. I really hope the U.S. can get over this barrier and provide health care for every one of its citizens. It can and does work!

    1. Lennox, Thank you for clarifying Laura’s comment. “But the bottom line is that everybody has access to good medical care.” Like you, I just don’t understand how people can accept anything less than that. You are so right about those two “dirty” words. I am glad to hear you’ve had exceptional care. Thank you for sharing and letting us know your system does work! It’s important for Americans to keep hearing this.

  5. Clarification on my part: It is considered Universal but in my way of thinking there is a “but,” which I should have stated. Each province is different in how they handle health care and what they pay for services. if you are in another province, not your own, and you require a doctor your health care card may or may not be accepted. If it is not then you have to pay, get receipts then submit them to your provincial healthcare provider, some will pay the entire bill, others will not.

  6. This issue is so frustrating and I am not smart enough to present solutions. But I am a little tired of some of the issues raised–like wait times in countries with universal care. When one is too poor to afford insurance and/or to go to the doctor in the first place–that wait can be forever rather than 13 months. Or if you live in a rural or under served area, one wait. I’m thinking of the traveling medical set ups in Appalachia. Or hell, even in my seaside town. When I got staph from my surgery, the cancer center misdiagnosed me as having shingles. As I suffered under the WRONG medications they were giving me, everyone seemed to be at a loss. Eventually they figured it out as staph, but in the meantime, they scheduled an appointment with an infectious disease specialist–but I’d have to wait 4 months. Because we only have ONE that serves the area and he only comes to the beach from upstate once a week.
    I’m also tired of hearing about keeping government out of health care. When I was in treatment I had to fight the insurance company because they didn’t think I needed a test or they wanted to control how I got nuelasta. No I don’t want the gov’t or anyone to get between me and my doctor–but I just have never experienced the pleasure of such “freedom”.
    Grrrr.

  7. While we aren’t as lucky in Ireland to have a system like the NHS, we still, with all its flaws, have a health system based on the right of all to access care. The health system is one of the things I’ve always found most confusing and disturbing about the US and your desire to see a universal health care system as a basic human right makes so much sense to me. I do hope it happens

  8. Hi Nancy,

    Well, from one liberal democrat to another, Amen! Health care is a basic human right. Here we are in the US, a relatively wealthy country from a global standpoint, and we don’t even take care of our citizens! What a shame, really. The ACA was a good start; it’s not flawless, but at least the new administration could’ve started from there instead of inventing a new health care act.

    I think Trump is so competitive, such a narcissist, such a bully, that he wants credit for everything in the world. I think that’s a huge reason why the Republicans tried to dismantle ACA.

    Healthcare is a basic human right!

  9. I do think health care should be a basic human right. It’s astounding to me how much of a mess this whole thing is, and that no one seems to be in agreement when it comes to how to fix it. Sure, the ACA wasn’t perfect, but it certainly provided coverage to many that didn’t have access before. And as you mentioned I don’t understand why we can’t work together on fixing that, rather than having to scrap a system that many were happy with and go with a whole new plan that sounds like it’s going to cover far less people. The whole thing is scary. There are so many unknowns, and having to life with the fear of not knowing if you’ll be able to have/afford health care is horrifying.

    1. Jen, Horrifying indeed. I agree completely that healthcare is a right. I do not believe it is a “product” available only to those who can afford to buy it. That to me, is immoral.

  10. And I can’t help but wonder why people aren’t mentioning the fact that pharmaceutical companies spend more on advertising than they do on research these days. When it comes to health care I think our priorities are completely screwed up.

Leave a Reply

Your email address will not be published. Required fields are marked *