The repeal of the ACA has created quite the firestorm, as expected. No matter where you stand on the issue the fact that remains is that there are people, namely poor, venerable, and sick that are the ones that are going to hurt the most from this. As a follower of Jesus, I cannot ignore this question, “But if anyone has the world’s goods and sees (a person) in need, yet closes their heart against them, how does God’s love abide in them?” (I John 3:17).
I am not an expert on healthcare, and I do not claim to have the answer. However, I do think it is important for fellow Christ followers (and others) to do what is right and stand up for those who have critical needs. If you didn’t see this from Jimmy Kimmel, take the time to watch, here.
My daughter is getting a Masters of science in nursing, family nurse practitioner – MSN, FNP at University of Colorado, recently wrote about this. The question was asked, if you had any suggestions for the amendment to better our healthcare system, what would those be? I have posted her answer below.
Amendments without repeal is the direction that I think we should be headed. Considering the extensive implementation process that took place with the ACA, just getting the millions of Americans signed up for their new insurance, and then actually putting their insurance to use, the repeal and then initiation of another system will be anything but beneficial to the public. One of the main aspects of the ACA that is under scrutiny is its longterm benefit vs damage in regards to the average American family’s economic sustainability and prosperity. The question whether or not widespread coverage is fiscally responsible and beneficial has long since been answered. It has been demonstrated over and over again that when preventative care is provided to the public at large, national spending on healthcare decreases. The ACA provides expanded coverage and access to preventative services for the vulnerable in our population. Speaking generally, It is the vulnerable that increase overall healthcare costs because before the ACA, they would only access the system through emergency services when expensive interventions were required. When primary and preventative services are provided, expensive tertiary interventions are decreased. This is why, after the reform failed to move forward in congress, we are seeing Republican states that had previously denied medicaid expansion through federal dollars, now looking to access federal funding through the ACA to provide coverage to their more vulnerable citizens. Why? Because when the vulnerable are left uninsured, overall healthcare costs increase. It is advantageous for these states to expand coverage, to decrease overall state spending.
Personally, I see it beneficial and actually quite necessary to continue to expand Medicaid throughout the nation. We run into a moral and ethical debate as we start to look at the effect of providing preventative services to the public at large and the effect that has on profit. In our country, healthcare is ran as a business, a true capitalist endeavor. The system is compensated for the services provided. In general, the more tertiary, the more expensive, the larger the profit. Therefore, it is impossible to ignore the inherent incentive within the system to keep the demand for tertiary services high. In a capitalist state, demand drives supply, which drives profit, which keeps the system afloat. So it makes sense, if we view the healthcare system as a business, aka as a for-profit entity, there is little benefit to keep people healthy and out of hospitals or in need of extensive procedures. I do not mean to say all the providers that benefit from these services are evil and are only in this for the money, that would be a waste of time to even try to argue, because I do not think that is the case. However, this is not based on individual intent, its just the reality of a business. It is driven by money. This is why I think it is impossible not to consider a completely different view of the healthcare system. When we consider healthcare as a service, there is an assumption that it requires compensation. If we considered healthcare as a necessity that every human needs access to regardless of status, then it starts to look more like a right. And if we consider something a right, why would be build a compensatory mechanism into it? Now, I do not mean that it should free. Because when people pay into something, they take ownership in it. However, if we make people pay per service, we will be building discrimination directly into our system. The rich get care, the poor do not. Simple. And regardless of morality, from an economic perspective, that doesn’t work. So, if we have all citizens pay into a system (based on income), and from that funding provided by the citizens, all humans are able to receive the care needed to maintain health, we would start to see the cost of healthcare as a whole, decline. I think I just described taxes. God forbid.
Right now, we have one foot in, one foot out. Which, as described above, won’t work. Its like two philosophies crammed into one system. Aka dysfunction and stagnation. A federal system that allows states to opt out (which was allowed by the Court in 2012) defeats the purpose of a national system and chops off its ability to succeed right at the knees (for lack of a better description). So, 2 paragraphs later, what I think we need to do is jump in with two feet. I think we need to commit to a single payer system and let it play out. The reason why that is going to be so difficult is because the thought of more taxes turns people off, for good reason. In our country, we have high taxes directly taken from our paychecks, as well as high out of pocket costs. I am not just talking about healthcare, I am talking about food, travel, mortgages, rent, etc. It is expensive to live in this country, and the more money taken from our paychecks, the harder it is to survive here. Lets take a quick look at Europe. Why does this kind of healthcare system work in Europe? Well, they are taxed at something like 50% (Germany is specifically what I am thinking of). Those taxes cover healthcare, paid maternal/paternal leave (after birth and to care for sick children), more vacation time, higher retirement pensions, more affordable housing, childcare, low-cost higher education, etc. So their out-of-pocket costs are significantly lower than ours. In fact, if you look at the amount of money Europeans are taxed, and the amount of money we spend on those services, we end up paying more. So perhaps yet again, the problem is this one foot in one foot out mentality. High tax for healthcare, does not benefit us in other areas of life that may be currently more pressing for certain members of the population (such as childcare expenses or affordable housing). Perhaps we need to start to consider a more socialist-minded approach to these services if we want to decrease overall spending in this country and ultimately improve the overall health and wellbeing of each citizen.