“I don’t want to terminate Obamacare, I want to REPLACE IT with MUCH BETTER HEALTHCARE. Obamacare Sucks!!!”
– Donald Trump
By Jack Bernard, contributing columnist
PEACHTREE CITY, Ga. | Recently appearing in a Modern Healthcare column entitled: “Trump attack on ACA elevates healthcare in 2024 election.”
But Trump has no new suggestions to fix the malfunctioning health care system. He never proposed anything specific to replace it when he was president. He just says that he will magically fix things, just like he did in 2016 when he convinced Mexico to build the wall and thereby solved our border immigration problem. Sure, he did.
On the other hand, it’s a fact that we have the costliest health care in the world, while still leaving 11 percent of working-age adults aged 19 to 64 uninsured. Not only that, our state of Georgia is the second worst state in the nation, with 19 percent of its working-age group uninsured.
It’s just plain wrong to attack the Affordable Care Act (ACA) without providing a better way to get people insured. The most recent data show that the ACA, or Obamacare, has drastically reduced the number of uninsured, an important accomplishment. However, 12 percent of Georgia’s total population is still uninsured. Only Oklahoma and Texas are worse.
In Georgia, as in the rest of the states, health insurance is delivered through many means. In our state, the majority of people are insured via employer-based insurance. Medicare and Medicaid make up over a third. The rest is Veteran’s Administration, Tricare, or purchased directly by citizens.
Because of our uniquely fragmented private insurance system, U.S. health care insurance coverage is a highly political “Rube Goldberg” rigged mess looked upon by other nations in disbelief. Corporate lobbyists throw money at politicians so that nothing (including access, quality, or cost) gets in the way of the corporate profit motive. Meanwhile, problems such as adverse selection, driving up costs for insurers who will then be forced to leave the market or raise rates, have existed and are growing issues.
Meanwhile, we spend much more of our Gross Domestic Product (GDP) on health care than other developed nations. When I became director of Health Planning for Georgia, we spent about 8 percent of GDP. We are now at more than double that … and still growing. Per one source- “In 2021, the U.S. spent 17.8 percent of GDP on health care, nearly twice as much as the average country who is a member of the Organisation for Economic Co-operation and Development (OECD).” And we are the only developed nation without some type of universal health insurance.
Further, the U.S. health care system does not deliver better results; the opposite is true. We rank 33 out of the 38 OECD nations for life expectancy. Think of it this way: we spend much more on health care than other nations and have much higher mortality rates.
Key players (large providers, insurers, big pharmaceuticals) hold all the winning cards. That can only be changed if there is one payer, Medicare, with enough clout to force change. Traditional Medicare has an overhead rate of two percent Private insurance companies spend 12 percent on marketing and overhead. (Those annoying ads are not free.)
What we need are political leaders willing to look at the facts, fight the entrenched special interests and pass Medicare for All. It’s not a question of having enough money. It’s all about taking on entrenched for-profit corporate health care. And Trump has shown that he will not do that.
- Have a comment? Send to: elliott@brack.net
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