The next evolution of American healthcare is here |
The next evolution of American healthcare is here
Every Democratic administration in the past century — no exceptions — came to Washington promising to rewire the healthcare system, mainly to protect Americans from the costs of illness. So did most Republican administrations (including President Trump’s). In the uproar of our times, few people noticed that the Affordable Care Act had already ended the long quest.
The program has flaws, of course — lots of them. But, for the first time, future administrations have the option to get to near universal coverage by building on what’s already there. That is a whole lot simpler than designing a new program from scratch, and it can be done through budget reconciliation, thus avoiding the dreaded Senate filibuster. The mix of Medicare, enhanced Medicaid, Affordable Care Act marketplaces and employer health plans make it possible to cover all Americans in incremental steps.
The Affordable Care Act, when it finally emerged from the fires of repeal efforts and court challenges, brought down the curtain on a long, political kabuki. Democrats kept proposing health reforms. Republicans would respond with shouts of “socialism” and offer more modest alternatives — less change and less government, more markets and more private sector.
Under the Obama administration, Democrats returned to power waving a variation of the old Republican alternative as their new plan, imagining that this time they might win bipartisan support. The Republicans again shouted “socialism,” and the wheel........