Fixing U.S. Healthcare – A Doctor’s Blog

Welcome to “Fixing U.S. Healthcare – A Doctor’s Blog.”

U.S. healthcare was a key issue in the 2016 Presidential election.  Bernie Sanders, Hillary Clinton and Donald Trump each promised to fix healthcare. Healthcare and healthcare costs were also a key issue in the 2018 mid-term elections and once again in the 2020 election.

President Trump and the newly elected 116th (2018) Congress faced the same obstacles to U.S. healthcare reform as confronted other Presidents these last 40 years — how to control costs and maintain quality while ensuring access for all.  And how to overcome vested interests and lack of political consensus.

Throughout his term in office, the President tried to tinker with stop-gap measures to fix specific problems, while asserting that “competition” would do the rest.

The Real Problem – Unsustainable Costs

But President Trump’s approach did not address the Real Problem with U.S. healthcare — relentless cost increases that are built into the system, but hidden from public view until recently.  In the campaign, President Biden and his fellow 2020 candidates all named those rising healthcare costs as a top campaign focus.

These now-not-so-silently rising costs are simply unsustainable.  They negatively affect the U.S. economy, politics and society.  In addition, many Americans are beginning to question whether they are getting their money’s worth from so much healthcare spending. Most importantly, healthcare costs are now hitting Americans directly in the pocketbook. All of their gains in wages during the first decade of the 2000s was offset by increased premiums and copays, keeping their take-home pay flat. Healthcare costs are now a top cause of household debt and often of bankruptcy.

This blog re-focuses on healthcare cost issues. It builds on a policy approach — cost-benefit analysis — pioneered in Oregon 25 years ago, which successfully restrained costs while maintaining near-universal access to costworthy, quality care.  It explores why an even more aggressive approach is now needed at a national level to solve today’s healthcare challenges.

In the face of the coronavirus pandemic, this blog has concluded that health, healthcare access, and the healthcare system are best understood as a public good, part of the social contract to which we all contribute in order to derive a greater collective benefit. So, in today’s complex society, good government must play an essential role in healthcare. Government should promote market mechanisms when advantageous and appropriate.  And government must be accountable to we-the-people and must be managed by skilled public administrators.  But fixing healthcare is too important to be left just to private corporations (especially monopolies) and other powerful special interests.

Visit here for a quick summary.

Updated January 1, 2021

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