The Affordable Care Act 2017 and Beyond

Since the election we’re heard every day that ObamaCare is dying and will be replaced by something better. That of course is the Republican version.

Here’s what’s really happening. The only way the Republicans can repeal and replace is to do it in steps with an appropriate time to phase it in. They simply don’t have the votes in the Senate to do it all at once. So they have to use reconcilement as a budget tool to get 51 votes to pass phase 1.

I’m concerned because many of the necessary items are either not being discussed or pushed off until phase 2 or 3. Real insurance reform has to be part of healthcare reform or you won’t lower insurance premiums. Reforming or lowering healthcare costs is an intricate part of insurance reform and needs to include but not limited to the following:

Items that need discussion and action are in no particular order:

  1. Tort reform-without tort reform, cost of healthcare will continue to rise to cover the cost of litigation. Congress has topo many lawyers to fix this but it has to be addressed. I understand that this is part of phase 2 but it remains to be seen how effective the legislation will be to turn tort reform around?


  1. Defensive medicine-a Doctor orders 10 tests when 1 is sufficient. They are doing this because if they get sued they can prove they actually was very careful to take everything into consideration regarding your care.


  1. Drug costs-Drug costs in the US are very high, in fact, higher than anywhere else in the world. One could ask why but the answer is apparent. Drug company lobbyists have Congress in their pocket. President Trump has mentioned that several times and I believe he is going to fix it. Just don’t know the timing? This is one of the most egregious parts of the current legislation that needs to be addressed if real reform is to take place. Without drug price reform we cannot lower healthcare costs.


  1. Transparency-Publishing the cost of procedures. This has a two pronged approach; one to let you see the cost from all hospitals and doctors in your area; (If you are paying a part of the cost shouldn’t you have a choice as to how much you pay?) two; allows you based on price, reputation, etc. to decide where and by whom you have the procedure. Wouldn’t you want to know how many procedures your doctor has performed and how successful those surgeries were?


  1. Doctor Networks-these insurance company Doctor and Hospital networks need to be increased to offer nationwide coverage so the patient has the choice, not the insurance company. Being an insurance broker I see this daily where clients cannot see the Doctor they want because he/she is no longer in the network. This needs to be addressed and soon.




  1. Lastly, and you will probably only see it here: Congress must be on whatever system they decide for all Americans. If they are included the deficiencies will be corrected. If they are not on the same system as the rest of the Americans, problems will continue because Congress has exempted themselves again. Don’t you think Social Security would be in better shape if Congress was on it? I think we all know the answer to that question.

Everything can be negotiated but will it be is the question?


Len Barend, The Barend Agency Inc.


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