Healthcare in the United States is a wicked problem: a labyrinth of public and private payers and bureaucratic policies that nearly defies understanding. There is no one simple fix for healthcare. That’s why we need experts who understand the complex system to work together with a short-term goal to provide universal coverage today and a long-term plan to build a comprehensive system to take care of all Americans in the future.
Our healthcare system in the United States has some of the best, brightest, and most innovative healthcare providers in the world delivering cutting-edge therapies. Our district is fortunate to include world-class hospitals performing vanguard research and offering quality care to enhance the lives of Arizona citizens and their families. A Mayo Clinic Phoenix heart transplant gave my friend Jeanne a new life, and the Honor Health Virginia G. Piper Cancer Care Network is helping my coworker’s 18-year-old daughter Brianna battle leukemia so that she can look forward to college and a bright future.
Yet, Americans pay more for healthcare than anywhere else in the world, and health outcomes in the United States lag behind those of other leading nations. For example, Americans pay some of the world’s highest prices for prescription drugs: 30 times more than people in the United Kingdom. But you don’t always get what you pay for. Americans die from treatable conditions 16% more often than the British despite the high price tags for care. Even with the tremendous gains in healthcare accessibility achieved by the Affordable Care Act, many Americans still face high deductibles and costs that pose significant economic risk. For many people, one trip to the emergency room – even with health insurance – could cost thousands of dollars and cause years of debt and financial instability.
In short, the American healthcare system is both the pinnacle of biomedical science, technology, and professional practice, and in desperate need of reform.
Naturally, the United States looks to other nations with excellent healthcare outcomes for models for reform. Many of these models represent some form of a single-payer system with universal coverage. Some national systems also incorporate private insurance options for those who wish to pursue additional coverage. These models offer future promise for improving health outcomes for everyone in the United States. However, it is critically important to recognize that no single-payer system exists in a country the size of the United States, or with the kind of existing healthcare system that is in America today. Efforts to move to a single-payer system cannot be implemented at the snap of a finger. However, it is feasible – and critical – to take steps today toward universal healthcare coverage to improve America’s health, economic stability, and national security.
What does healthcare reform look like? I believe early efforts should focus on taking what works and expanding it.
One simple way to reform healthcare, since Medicare was implemented a half century ago, it has improved health and reduced poverty for Americans over the age of 65. Based on the core concepts of insurance systems, it makes sense to allow younger Americans to opt-in to buying Medicare coverage starting at age 55. Medicare buy-in options would improve the function of Medicare as an insurance system by introducing younger and statistically healthier individuals into the coverage pool. Medicare buy-in would also improve private insurance markets by reducing the number of individuals with more chronic health conditions from the private market pool. Medicare buy-in offers a win-win across the insurance market.
I believe another opportunity would be to offer a Medicaid buy-in option. Arizona is a leader in Medicaid services, with our AHCCCS program recognized as the gold-standard model for Medicaid nationwide. Currently, Medicaid is available to lower-income Americans with individual contributions on a sliding-fee scale based on annual household income. Although Medicaid is not perfect, people with Medicaid coverage are generally satisfied with their healthcare, and experience significantly improved health compared to individuals who are uninsured.
Since the Affordable Care Act was introduced, millions of Americans have benefited from access to preventive healthcare services including vision screenings that help kids succeed in school, and cancer screenings that save lives. These services make people’s lives better. When people are healthy, they contribute to our society and make America stronger. We need to fix the ACA, not scrap it for a complex formula that leaves millions of working Americans out in the cold.
In addition to fixing and improving healthcare coverage, we need to address the high costs of prescription medications that plague Americans with acute and chronic healthcare needs. As a nurse practitioner caring for people with chronic health conditions, I have seen countless patients who struggle to afford the medicines that keep them alive. No one should have to choose between paying for medicine and paying for food. Similarly, public health systems should not have to ration access to new therapies for vulnerable populations due to extreme pricing of new medications. At the same time, no one wants to stifle innovation by restricting biomedical technology firms’ ability to do cutting-edge research and development. We need smart solutions to control costs and maximize outcomes for patients and innovators alike. If we bring together the best and the brightest from all sectors of healthcare innovation and delivery to focus on the future, we can build and implement those smart solutions to benefit all Americans.
Finally, as important as ensuring affordable access to care, healthcare reform must tackle the problem of administrative burden on our nation’s healthcare providers so that they can step away from the computer and return their focus to the patient, delivering high-quality evidence-based care to help people lead healthy and productive lives.
The bottom line? Our healthcare system needs healing. As a Doctor, Nurse Practitioner, and Professor I’m ready to do the hard work to take care of America’s health today and make us better for the future.