Why Either Administration’s Healthcare Policy Does Not Cut It

Author: Valerie C

I walked into the hospital, a place brimming with all emotions, prepared to face the day ahead. As a student, my role is to learn from the nurses and to understand what my future profession is. From what I have seen, it consists of education, communication, an artistic science. For the amount of education nurses give their patients, the healthcare professionals I have come into contact with are acutely unaware of the financial expenses their procedures are. A single administration of a medication charges 8 dollars. A surgeon’s procedure costs thousands. Medicare or Medicaid covers part of the expense, other insurance companies potentially cover the expense, yet without proper research prior to visitation, individuals face expensive charges that lead into crippling debt. 

So what policies have been enacted to mitigate these expenses. 

Let’s start with ObamaCare, formally known as the Affordable Care Act: 

ACA enabled those with pre existing conditions to gain coverage as most private insurance companies shy away, or out rightly refuse, from providing coverage if the perceived risk was too high. With the Affordable Care Act, the percentage of uninsured individuals dropped by approximately 5% points. It enabled young adults to remain on their parent’s employee coverage. The policy expanded Medicaid and Children’s Health Insurance Program  to provide coverage for low – income families – a necessary expansion given that those facing economic challenges, as an individual or family unit, are at higher risk for a variety of health complications. The compromise was an adoption of the program, each state deciding on program compliance. In addition, ACA formed consumer protection, enabling every individual to undergo preventative health checks including cancer screenings, be charged equally regardless of pre-existing chronic health conditions, and mandated all essential benefits be included in every coverage plan. 

Are there many coverage gaps with the Affordable Care Act? Yes. However, does the policy expand coverage to those who previously did not hold insurance plans? Yes. Does it promote health and wellness to the most compromised populations? Yes. Does it though place limitations on the amount of visits you may make with your physician, does it carry high – deductibles and force users to pay out of pocket when a medical emergency occurs? Yes. Does it limit the type of care beneficiaries may seek? Causing unnecessary financial strain if an emergency occurs and the only physician is ‘out-of-network’? Yes. Did it fully act on its’ promise to cover every individual with preexisting conditions and to lower the cost of private insurance beneficiaries? Heck no. Prices for some private insurance drastically increased given the federal alternative, and only a sliver of those with preexisting conditions used ACA. Nonetheless, the policy attempts to expand healthcare coverage federally for those who otherwise have NO access. It is a step in the right direction. 

Now lets compare the more recent America First Healthcare Plan set out in August by President Trump:

President Trump has not repealed or replaced the Affordable Care Act. After four years of coming up with ideas, the Act still stands as the main resource for millions of Americans. Though he claims the Act is dead, that is certainly not the case. The American First Healthcare Plan has positive points, increasing access of healthcare plans for small businesses, lowering premiums in select states, using innovative techniques to have patients carefully send their medical records to providers of their choice, lowering prices of Insulin and epinephrine, and enabling the government to undertake the payments of Covid testing. President Trump focuses more on the companies providing the care rather than the individual. This is not a malicious, nor inherently poor choice; instead, it is a decision that if the system morphs into an encouraging facilitator for private entities, then the competition will lower the prices for the consumer, enabling those previously uninsured to reap the benefits. The American First Healthcare Plan essentially exists as a case study for The Invisible Hand. Like with any policy, there exists numerous nuances that take time to declutter. However, the striking flaw of the policy remains, is our healthcare to be a business or a right. 

I finished my ten hour clinical rotation, drained and exhausted. I think of my patients, now referred to as clients in our textbooks, and ponder how encompassing their policies are. Will their stay in the hospital for necessary surgery prove not worth the cost?