There is no shortage of ideas for reducing government healthcare spending, and for every option there are several strong opinions. The past few weeks I have researched most of these alternatives, including the pros and cons of each. I don’t mind admitting that this has been a difficult subject to boil down, mostly due to the number of concepts and the vast amounts of information on each.
In addition, the amount of contradictory information and viewpoints has made it difficult to separate the wheat from the chaff. I’m sure the powerful emotions surrounding this issue have added to the volume of arguments for and against. After all, Congress has been fighting over the Affordable Care Act (ACA, aka Obamacare) for over six years.
Republicans in the House of Representatives have voted over 65 times to repeal Obamacare, and although it’s evident that it’s been mostly for political reasons, they’ll keep doing the same thing between now and the end of 2016. Obviously, nothing is going to change before President Obama leaves office.
Despite this, even if Republicans win the Whitehouse in 2016 and maintain their majorities in the House and the Senate, I believe it’s unlikely that they will try to repeal the ACA. The law is becoming more popular and the healthcare system is adapting to it. Recently, for the first time, polls show that more Americans favor the ACA than not (44% favorable, 41% unfavorable), and this positive trend in public opinion seems likely continue.
Repeal after 2016 will most likely be too painful and politically unattractive for Republicans. It would probably lead to substantial social upheaval and throw the healthcare system into disarray. The political blowback from repeal would not only give Democrats a rallying point, but could cause significant voter backlash.
But even if the ACA remains the law, our spending on healthcare will still be too high. Federal spending on healthcare continues to grow. The non-partisan Congressional Budget Office (CBO) estimates that federal spending on healthcare will reach 30.8% of total spending by 2025, up from 26.4% in 2014. And these numbers reflect the ACA remaining in place. If the ACA is repealed the CBO has recently estimated that the deficit will increase an additional $137 billion to $353 billion in the next ten years.
With or without the ACA, this level of spending is unsustainable.
Although nothing will change before the next president takes office in January 2017, given the seriousness of this issue, Congress must start working on it soon after the inauguration. Republicans should then move their position from repeal, to fix and improve; and Democrats will need to be more realistic about healthcare spending. Both parties must be willing to work on a bi-partisan plan to improve not only the ACA, but all other government-funded healthcare programs. It’s time for both parties to find common ground and begin working on solutions.
Voters have grown weary of this issue. A Gallup Poll in May showed that only 5% called it the country’s most important problem, down from 26% in September 2009. Since most Americans are tired of the healthcare debate, one would think that by 2017 this kind of bi-partisan approach will be appreciated by most everyone. Whatever lawmakers come up with, it needs to get done no later than the end of 2017, and before the election year of 2018.
The usual approach to health care policy has been passing laws that are several hundred pages long, and writing regulations that are tens of thousands of pages long – like the ACA. It seems to me that instead we need to come up with some solutions that are more market-driven, entices people to become better healthcare consumers, and with few additional regulations. Using a system of incentives and disincentives should make a bigger difference more quickly than thousands of pages of additional regulations.
The most difficult political challenge for healthcare spending reform that will continue is big money from special interest groups. Politicians in both parties have come to rely on the healthcare sector to be among the largest contributors to their campaigns. The best way for politicians to keep that money flowing has been keeping healthcare professionals and insurance companies riled up. It’s hard to imagine that these tactics will stop, and it’s one of the primary reasons this issue remains unresolved – shame on them.
I need another week to continue whittling down my ideas for reducing healthcare costs. I appreciate your patience while I do that.
Links to related blogs:
We’re spending too much on Healthcare: http://www.commonsensecentrist.com/were-spending-too-much-on-healthcare/
Medicaid and Obamacare: http://www.commonsensecentrist.com/medicaid-and-obamacare/
More on Medicaid and Obamacare: http://www.commonsensecentrist.com/more-on-medicaid-and-obamacare/
Medicare turns 50 – will it survive another 50 years: http://www.commonsensecentrist.com/medicare-turns-50-will-it-be-around-another-50-years/
Options for Fixing Medicare Spending: http://www.commonsensecentrist.com/options-for-fixing-medicare-spending/