The Affordable Care Act (ACA), otherwise known as Obamacare, set out to repair problems inherent in our broken American healthcare system. Many people opposed this new law, yet it rolled out none the less. Now, we are realizing that while the ACA created health insurance for more American lives, it did not necessarily provide healthcare. A meltdown of the American healthcare system seems to be happening right in front of our eyes.

The ACA, in fact, made healthcare more inaccessible for many. Sure, they currently have healthcare insurance but this is not translating into actual medical care. For one thing, the premiums of healthcare plans are quite costly for many but people are forced to pay or face tax penalties. While they are being squeezed to pay these premiums, these insurance plans carry very high deductibles, often over $10,000 a year. Most patients do not spend that much on healthcare so these plans, in essence, serve more as catastrophic plans.

Additionally, under these new insurance exchange plans, services are frequently cut dramatic. Formularies, or a list of medications that an insurance company will pay for, is often narrowed to the very cheapest medications. A patient may have been doing well on a certain medication for many years, now they are forced with the choice or changing to an alternate drug or paying for the one that works for them out of their own pockets. Also, diagnostic tests are now being doled out for limited conditions. A patient with a possible malignancy often waits to  get prior authorization for the test that will diagnose them. Many times, it is denied and a lengthy appeals process ensues. And the decision just boils down to cost-savings for the insurance companies.

We have a system where patients are going bankrupt getting medical care while being squeezed to pay insurance premiums. We are the only country in the world where medical costs are a significant contributor to bankruptcy filings. Healthcare has become unaffordable and many people are suffering because of it. Add to that is the fact that insurance premiums increased substantially across the board this year. You can only bleed so much money off a person before they simply cannot pay any more and then must self-ration their own health. Insurance companies are ransoming the wellness of Americans.

And if that weren’t bad enough, the newly elected President, Donald Trump, sounds off that he plans to repeal the ACA as soon as he takes office. He neglects the fact that millions of Americans have coverage through ACA plans and if he repeals it immediately, those plans no longer exist and it leaves millions uninsured despite the fact that they are paying premiums. And he has no good plan to replace it with. He has mentioned, on another occasion after meeting with President Obama, that he would repair the parts of the ACA that are not working. So, what will it be? Repeal and cast millions into chaos or keep and repair it? There seems to be no good answer here but the calls to repeal the ACA keep being hurled about by the future POTUS.

The healthcare system is melting down leaving Americans without access to medical care and it seems the incoming president’s vision is to make it worse. We need a real plan that gives affordable care back to Americans. Who is going to devise that plan?

© 2017, Linda Girgis MD. All rights reserved.

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2 thoughts on “The Melt Down of the American Health Care System: What’s Next?

  1. getting acquainted with this fine blog.

    Interesting to read a post written six months ago, not knowing what will transpire, then seeing what has transpired. The perspective of the Dr has to differ from the perspective of the policy maker. Make it into my exam room and a history will be taken, an exam will occur and responsible medical decisions will be offered. while the no questions asked medicines are economical, the expensive ones are available if I provide justification. The ones that get turned down each year I can count on the fingers of one hand though it is sometimes a nuisance to go through my record to extract the justification. Sophisticated specialty care is available, but you have to get into the exam room first. And we have ways of keeping people at arms length, those without referral mostly.

    The Congressional debate had little to do with the core values of protecting people at their most challenging personal times, which is one of the prime roles of government, but of techniques that will shield proposals from scrutiny and amendment. If we learned anything it is what we should have been able to figure out without this exercise, that one side cannot really bludgeon the other, or at least not for very long. There is always a default, and if you want to improve on the default you have to analyze what constitutes and improvement and create enough of a consensus to move ahead

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