What Next for GOP Healthcare Plan?

Whatever GOP leaders may actually be thinking, it's clear that the time has come for bipartisan healthcare reform.


The irony of all ironies. The GOP healthcare plan defeated by the GOP! And I'm glad, given all the well-documented problems with the bill.

The Congressional Budget Office or CBO estimated that 17 million to 24 million Americans would lose their health insurance under the GOP repeal and replace plan. I would have been on top of the list, because I am over 60 but not old enough for Medicare. My grandfather was a Marine in World War I. Both my parents and all of my uncles served in World War II. My grandparents on my mother’s side came to Ellis Island a century ago. I am a red-blooded, patriotic American. How dare they try to take away my health insurance.

See also: Is U.S. Healthcare Ready for ‘All Payer’?  

I get that the ACA has major issues and needs fixes. I, too, have several issues with the ACA, including the employer mandate and how small employers are charged premiums under the ACA. (See: "A Quiet ACA Waiver -- and Needed Change," from April 2014.) I am on board with healthcare reform but not when it's done on the backs of small employers.

Americans do need sound options for affordable healthcare coverage based on their needs. I get it.

The American public is sick of this political nightmare. The GOP thinks they need to repeal Obamacare to get reelected. Hello, the American public was 56% to 17% against the GOP plan. It is time for a bipartisan approach to healthcare reform. 46 U.S. Democratic senators just signed a letter that they be open to bi-partisan discussions to improve and provide fixes to the ACA, as long as the outright repeal of the ACA is not part of the deal. President Trump also just stated he'd be very open to discussions with the Democrats. Where does it say in the Constitution that to pass a bill in Congress all the votes have to come from one political party?

In addition, several moderate GOP congressmen were not in favor of the bill. My congressman, Rodney Frelinghuysen (R-11th NJ District), and three other Republican congressman from the Garden State announced opposition to the GOP bill for the right reason. It would have hurt the poor, the elderly and working families in their districts. Their offices were flooded with constituents opposed to the plan, along with powerhouses like the AARP.

The bottom line and reality is healthcare costs are never going down. We have an aging population of baby boomers with a ton of health problems, now and coming up. One of the major problems with the ACA is that the costs cannot currently be sustained, and a major reason is that 45% of the millennials ages 18 to 30 have not signed up, even though the overwhelming majority voted for President Obama and the Democratic party.

We have the best healthcare in the world in the U.S. Hands down. However, it is terribly wasteful, inefficient and fragmented. We still rely basically on a fee-for-service system that results in unnecessary and even harmful medical care. (See: "Unnecessary Surgery: When Will It End?" from October 2015.)

The only way to a lasting bipartisan agreement is to find common ground one issue at a time:

--Start with the major premise of the ACA, that Americans cannot be denied coverage for a pre-existing condition. Check.

--Next, help small employers hurt by the ACA and rising premiums.

--There appears to be widespread agreement to allow small employers to ban together in risk pools similar to workers' compensation.

--Chuck Schumer just indicated a willingness to give the 50 state healthcare commissioners more power and control over premiums in their state. Remember healthcare, like politics, is all local.

--Consider tort reform based on the use of documented medical protocols by medical professionals. Millions of unnecessary tests are performed every day due to medical providers' fear of a potential malpractice claim.

--Pass a bill to help medical students with their tuition and student loans if they will help serve as primary care providers in poor or rural neighborhoods for a year or two.

See also: Healthcare: Asking the Wrong Question  

There are a ton of good ideas out there that we spend our healthcare dollars on, including prevention and wellness and not sick care.

The time for bipartisan reform is now.

Daniel Miller

Profile picture for user DanielMiller

Daniel Miller

Dan Miller is president of Daniel R. Miller, MPH Consulting. He specializes in healthcare-cost containment, absence-management best practices (STD, LTD, FMLA and workers' comp), integrated disability management and workers’ compensation managed care.


Read More