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Healthcare Reform Needs to Improve Access to Care, Panelists Say
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Healthcare Reform Needs to Improve Access to Care, Panelists Say

Laura Joszt
A day after House Republicans voted to pass legislation that repeals and replaces large parts of the Affordable Care Act, Avik Roy, Forbes opinion editor and president of the Foundation for Research on Equal Opportunity, outlined what Republicans are trying to fix. After his presentation, he joined a panel discussion on what impact the American Health Care Act will have.
A day after House Republicans voted to pass legislation that repeals and replaces large parts of the Affordable Care Act (ACA), Avik Roy, Forbes opinion editor and president of the Foundation for Research on Equal Opportunity, outlined what Republicans are trying to fix. After his presentation, he joined a panel discussion on what impact the American Health Care Act (AHCA) will have.

During his presentation, Roy made the argument that healthcare is actually simple, but over the last 50 years the United States has managed to “mess it up.”

The current “behemoth” grew out of changes that began in 1965 when the country decided it was “intolerable” that the elderly, poor, and disabled couldn’t afford health insurance and created Medicaid and Medicare. There was a system where the consumer was far removed from the actual purchase of healthcare. As a result, they became insensitive to costs. Meanwhile, the advent of Medicare meant doctors and hospitals could charge higher prices and Medicare had to pay the claims.

Roy does believe that the country should strive to provide everyone with affordable health insurance, but the way the United States has gone about doing it was “incoherent” and expensive. There are 2 ways that other countries have done it effectively: a single-payer system or a market-based approach.

“Our approach, uniquely, takes the worst of both,” Roy said. “We have all the cost inefficiencies of a highly public system without any of the actual coverage gains that you would expect from a truly government system.”

One main thing Republicans don’t like about the ACA is that they think the government should be smaller. Republicans like to call the ACA a “government takeover of the healthcare system,” but they’re missing something when they say that, according to Roy. Even before the ACA was enacted, the government was spending far more on healthcare through Medicare and Medicaid than it will pay on the ACA.

“If the goal of conservative health reform is to really make the healthcare system in America fiscally sustainable, it can’t be just about Obamacare,” Roy said. “It has to be about reforming Medicare and Medicaid, as well.”

He outlined 4 steps to address the issue:
  • Reform the regulatory framework of the exchanges so there are no big spikes in premiums while keeping basic protections like guaranteed issue. Subsidize coverage in a means-tested way.
  • Raise the eligibility age of Medicare once the markets stabilize.
  • Privatize and restructure Medicaid. Take the able-bodied, acute care population in Medicaid and migrate them into the market. Give states more responsibility for the long-term care population.
  • Finally address other necessary reforms, including addressing rising drug prices and hospital consolidation.

“This could be an approach where progressives and conservatives could both win,” Roy said. “We could have more people covered than in the ACA, but also have significant fiscal savings.”



 
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