With last fall’s government shutdown, health care is back in the spotlight as a major policy focus in Washington. Democrats believe that making the midterm elections about health care will favor them. This is an issue that has historically favored Democrats with our latest survey for Winning the Issues showing health care issue handling at 34-53 R-D. But as the Affordable Care Act’s structural flaws are becoming more obvious, tinkering around the edges of a flawed system isn’t enough.
Voter dissatisfaction with the current system is not a surprise, at 38-59 satisfied-not satisfied from our November numbers. While Republicans believe the ACA was the wrong approach, the larger problem with the ACA is that it is obsolete. When it was passed in 2010, the ACA was designed to address problems of the health care system that existed almost two decades ago. As a result, health care policy in Washington is treated as a financing problem more than a health problem.
The skyrocketing costs of chronic disease are taking their toll on the US economy. CDC estimates of annual costs of disease impact show diabetes at $413 billion and Alzheimers at $360 billion, and these figures are increasing every year.
There are two categories of health care policies needed: policies to address the current system especially around quality and cost, but with another important category of policies to address the future of health care through incentivizing health outcomes and addressing chronic disease.
As we have seen over the past year, Congress is asking new questions about the return on investment from federal dollars and how to incentivize better health outcomes rather than simply funding a reimbursement model (see our post here). This will be the new standard to which players in the health care industry will be increasingly held in the future.
In the current environment, we are seeing hospitals, insurers and pharmaceutical companies blaming each other for rising costs. But this means they are fighting over the status quo within the health care system. The real question becomes how do we move beyond the status quo system and develop policies that promote innovation and health — and who is staking out leadership in this area? If the private sector is not seen as the solution to the future of health care, this creates a clear opening for a larger government role.
Next week, we’ll be writing about what we are seeing in views of the government role in health care and Medicare For All.
