We’re All in This Together
The last election was a stark continuance of the polarized status of our politics and even our country. Both sides disagree on fundamental issues, and at times, it appears there is no attempt to even listen to the other side. This is the environment we find ourselves in, and with one party having won the majority in the House and the Senate, as well as capturing the White House, it looks like this polarization is going to be magnified. As we look forward to 2025, from a healthcare perspective, it’s easy to think that any compromise or bipartisan solutions may be out of the question. You and I will be at the mercy of a polarized government that will jam whatever shortsighted, politically motivated legislation that seems advantageous to them down our throats without any consideration for what might be best for the patient. Well . . . let me see if I can give you some hope.
Contrary to what some say, I believe that doctors care about their patients, hospitals provide lifesaving care, insurance companies don’t want us to go broke or miss out on needed care, and drug companies work hard to find new treatments that improve or even save our lives. Are there problems that need to be dealt with? Absolutely. Is there widespread disappointment with our current healthcare system? Yes. The unfettered response to the shooting of the United Healthcare CEO was unexpected. The mindless killing of a respected businessman should only bring a universal rebuke of such a horrific act, yet many used his death as the opportunity to voice their disapproval of our overall healthcare system and the insurance business in particular. While I strongly believe that this is neither the time nor the venue for voicing their disdain for this part of our healthcare system, I’m not going to ignore the pent-up frustration that was demonstrated, and I don’t think the incoming administration will either. So … why should we have hope?
As I advocated for seniors in the first Trump presidency, I observed an interesting transformation. Changes to our healthcare system that had been out of reach for over a decade suddenly became obtainable. The Trump Administration suddenly made the implausible possible. For instance, a yearly cap on Medicare Part D costs for patients and fixing the prices of prescription drugs at some level had been debated since I started in public policy in 1996, but neither one even came close to being considered. Suddenly, through the disruption of the Trump administration, these issues were on the table for discussion. I think this transformation legitimized the discussion and allowed these two changes - one bad, one good - to be considered and ultimately passed during the Biden presidency. Already, with the president-elect’s cabinet choices and the creation of the Department of Government Efficiency, it is evident that no healthcare policy is off the table. From my point of view, these next four years will see some changes in our government, especially in healthcare.
This leads to my hopefulness. Many of the problems with our healthcare are due to the patchwork way it has evolved, both commercially and within Medicare. Employee-based healthcare was a way for companies to lure employees after World War II when, in an effort to reduce inflation, the government-controlled salaries. Many economists today think it would be more efficient to decouple healthcare insurance from employers. Fee-based payments have long been a reason that Medicare’s costs are high. We are trying to migrate to more cost-effective value-based payments, but it is hard to change the entrenched way of paying and administering Medicare. The program is so big that it’s hard to change. The GLP-1 weight loss drugs that are sweeping the nation have proven their effectiveness in treating obesity, but only recently has it been proposed that Medicare pay for these drugs purely for weight loss. Even though it has long been known that obesity has a huge and costly impact on our health, and these drugs would likely save billions of dollars in the long run, it is still a battle to get them approved for payment under Medicare. Changes to these embedded government programs are hard.
With the indication that the Trump administration is willing to attack these bastions of tradition, I hope that we can correct the inefficiencies that have caused us to distrust and criticize our present system. It will be up to us to work together to ensure that the older American’s perspective is considered in these changes.
I challenge us all to make a two-prong New Year’s resolution concerning healthcare. First, keep an open mind on any proposed changes. Don’t be so quick to criticize any one part, instead look for ways that we can streamline and redesign the whole system to make it work better. Second, take responsibility for your own healthcare. Hopefully, you have found the best program for you during the open enrollment period - now make it work for you. If some aspect of your care has been denied by your insurance company, you have the right to appeal. An extremely low percentage of denials are appealed. Do the things that make you healthier, and be the one in charge of your own health.
I’m looking forward to next year, it’s going to be quite a ride. I hope you stay involved and be part of creating a better healthcare system. Remember, we’re all in this together.
Best, Thair
P.S. I hope you and yours have a great holiday and a happy New Year. See you in 2025!