Since Donald Trump has been elected President of The United States, the question that is on the minds of every healthcare organization is “What will be the fate of Obamacare?” During HIMSS 2017, I had the pleasure of listening to two political heavyweights on either side of the political landscape of America on this subject.
Former Republican House Speaker John Beohner and Democratic Governor Ed Randall were candid in their comments on what they see as the future of Healthcare in US. Governor Randall emphasized that there were two aspects to the Affordable Care Act popularly known as Obamacare. The first aspect was accessibility and the second aspect was affordability. Obamacare has been quite successful on the accessibility front and has increased the access by around 20 odd percent. But, on the front of affordability, the program has not done well and has resulted in increasing premiums and many partners dropping out thus reducing the options. Thus, he mentioned tongue in cheek, the need to repeal Obamacare and replace it Affordable Care Act!!
Speaker John Boehner seemed to agree with Governor Randall and mentioned that he expects most of the framework of the Affordable Care Act to remain intact. But he felt that states would get more control in deciding the policies to offer and how to run these policies within their states. Also, few glitches such as a missing public option will need to be looked at and some way to incorporate it into the Affordable Care Act will need to be figured out.
Again, Governor Ed Randall seemed to agree, but mentioned that whenever the federal government talks about increasing control in the hands of the States, they actually mean cutting the funding from the federal government to the states. In such a scenario, he felt with the increased coverage, many states would struggle to balance their budgets. So the new act needs to take this into consideration as well.
Moving on, both briefly touched upon the spiraling cost of healthcare. Again both seemed to be in agreement one of the key evils is the election funding. A lot of healthcare players tend to fund a lot of elections and hence the politicians usually have a vested interest and hence do not take enough steps to control the costs.
Looking forward to the solutions, both again felt that IT could be the key and solutions such as home care and targeted healthcare solutions could help bring down the cost of healthcare. But, with so many solutions and ideas being tossed around, bureaucrats and politicians find it very difficult to sift through these and pick the winners. Thus, there would be some missteps before the right steps are taken up.
On President Trump, Speaker Beohner mentioned that his reign is going to be like his campaign – Raucous, Incoherent, Hurt a lot of sentiments, but still very effective!! Trump will bring in efficiency into the way system works, but the other aspects will continue to be a distraction. The key challenge for Trump would be whether he is able to reach out to the leaders of the Senate and the House.
At the end of it all, it was heartening to see that the gap between the two parties is not as big as it has been made out. May be it is retirement, may be it is just that they do not need to worry any longer about getting elected, but after the bitterness of recently concluded elections, it was just good to see two politicians from both sides of the aisle sit down and talk the issues in a calm and constructive manner. I think that itself was a quite heartening for Healthcare Industry and hopefully the mess will shortly clear up.