Trump’s new secretary of health and human services intends to make life better for physicians.
.. The men often contorted their faces when speaking the word “Obamacare,” as if it produced an acrid taste—though they used the term effusively.
.. The New York Times editorial board described Price as “a man intent on systematically weakening, if not demolishing, the nation’s health-care safety net.”
As Price puts it, though, the goal is rather to improve patient-doctor interactions.. In an attempt to contain spending and ensure quality, Medicare and Medicaid come with guidelines that dictate reimbursement. Many doctors find the systems’ requirements tedious and cumbersome—a common and serious complaint among doctors, who tell me they feel the art and autonomy of medicine are lost amid tedious paperwork and other minutiae. .. Downsizing these programs would mean freeing doctors from dealing with patients insured by the cost-containing plans that many feel are too bureaucratic.
.. Trump has promised not to dial back the programs that have accounted for so many insured Americans, in no uncertain terms (“I’m not going to cut Social Security like every other Republican, and I’m not going to cut Medicare or Medicaid”). But the President-elect’s website has since changed its language on the issue, saying it will “modernize” Medicare.
.. If you have a gap in coverage—for example, if a sick person gets fired and doesn’t immediately find another job that provides coverage (or purchase individual coverage)—then the insurance companies can raise premiums.
.. the idea of saving a stack of tax-free cash to purchase your health care sounds in ways idyllic—but impractical when care costs as much as it does in the U.S. The average person incurs more than $10,000 in medical costs every year
.. The exorbitant system costs are the result of oligopolies: privatized insurance corporations, pharmaceutical and medical device corporations, and health-care systems. All of these things Obama attempted to moderate with the Affordable Care Act, and all stand to be repealed.
.. Were Price’s plan fully carried out, that could potentially do more to exacerbate the rift between rich and poor than any other cabinet member
.. Republicans like Lamar Alexander, chair of the Senate Health, Education, Labor and Pensions Committee, have said that realistically, any holistic replacement of the Affordable Care Act will take years.
The First Victims of Repealing Obamacare will be the Sick and the Poor
he would roll back the expansion of Medicaid that has benefitted millions of poor families and return the country to a system where private insurers have little incentive to cover high-risk individuals.
.. If Trump’s real goal is to return to a market-based health-insurance system, with all the inequities and gaps in coverage that such a system inevitably entails, Price’s plan presents a possible blueprint for how to get there.
.. Under Price’s plan, reversing the post-2010 expansion of Medicaid alone would mean that about fifteen million people would lose their health-care coverage overnight. These people—members of families whose earnings are above the poverty line but less than forty thousand dollars a year
.. Even now, it is hard to see exactly how he will be able to both follow Price’s lead and keep his pledge to people with preëxisting conditions.
.. Under Price’s plan, insurers would still be legally obliged to offer coverage to sick people, but they could charge much higher premiums to anybody who hadn’t maintained continuous coverage—a loophole that could potentially affect millions.
.. The health-care economy that emerged from the Affordable Care Act is a Rube Goldberg contraption with many interlocking parts: laws, taxes, subsidies, public mandates, and administrative directives, along with the expansion of existing features, particularly Medicaid. Some of these pieces may have appeared to be superfluous, but they were designed to work together and support each other. If someone comes along and fiddles with one of them, such as the subsidies or the individual mandate, it can affect the entire system.
Tom Price’s radically conservative vision for American health care
President-elect Donald Trump sends a strong signal he may look beyond repealing and replacing Obamacare to try to scale back Medicare and Medicaid, popular entitlements that cover roughly 130 million people, many of whom are sick, poor and vulnerable. And that’s a turnabout from Trump’s campaign pledge — still on his campaign website — that he would leave Medicare untouched.
.. His vision for health reform hinges on eliminating much of the federal government’s role in favor of a free-market framework built on privatization, state flexibility and changes to the tax code. The vast majority of the 20 million people now covered under Obamacare would have far less robust coverage — if they got anything at all.
.. “Between this nomination of an avowed Medicare opponent to serve as HHS secretary and Republicans here in Washington threatening to privatize Medicare, it’s clear that Republicans are plotting a war on seniors next year.”
.. “To put in charge of the nation’s health care system and a trillion-dollar budget someone who has never overseen anything larger than a congressional committee ought to raise eyebrows when this position has historically been reserved for an individual with significant administrative experience,” said Rep. Steny Hoyer.
.. “In general they’re trying to shift risk from the government to individuals, and particularly to low-income individuals,” said Topher Spiro, who heads health policy at the left-leaning Center for American Progress. “It’s hard to see how that’s giving them a leg up, and how that’s improving the quality of their lives.”