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 was also a key issue in the 2018 mid-term elections. Now, once again, leading up to the 2020 election, healthcare and healthcare costs are a top voter issue.

President Trump, the newly elected 116th (2018) Congress, as well as candidates for the 2020 race, face 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 2017 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 the President’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.  Many of the President’s 2020 challengers have now 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.

But even bold plans like Medicare-for-all won’t by themselves control costs.

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. Visit here for a quick summary.

Updated October 23, 2020

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