Ever since the debate and passage of the ACA, it appears to me that the biggest issue in the debate is the rising cost of health care. But I feel like it's the issue that the ACA completely ignores. I have always maintained that making health coverage affordable is far more important than making sure everyone is insured. Healthcare contributes to 42.6% of all bankruptcies. Lowering the overall cost of health care across the board increases the stability of the system and benefits consumers on all ends of the spectrum. The poor and middle class would benefit the most from a drop in costs for the same reason they are hurt the most by increasing costs. A $12,000 premium is relatively very expensive for a family of four living on $60k a year. I'm not at all convinced that the major portions of the ACA will lower health care costs. Quite the contrary, it shifts costs from Americans 50 and older who consume a higher level of health care to newer workers under 40 who make less money (less years in their career) and often have many other costs such as a new mortgage, daycare, saving for college, etc. that older Americans don't have to assume. It also raises a moral question. Is it moral to force one group of people to pay more so another group can pay less? Wouldn't a better solution be to lower costs across the board so that both groups benefit?
I also want to discuss the shortage of doctors. The great paradox with the ACA is this. We already have an enormous shortage of physicians. I always here liberals complain about the pay of doctors in the U.S. as compared to the EU, but they never give a valid explaination as to why that is except for saying they are greedy. "What we’re looking at now is that there’s a shortage of somewhere around 90,000 physicians in the next 10 years, increasing in the five years beyond that to 125,000 or more,” says Atul Grover, MD, PhD, chief public policy officer of the Association of American Medical Colleges." The fact is, we don't have enough people becoming physicians in this country because school costs upwards of 200k+ and we do not have enough residency spots to train graduates.
So what does the ACA do about it? It cuts $1B from Medicare funds to residency hospitals. " Now there are going to be an additional 30M extra patients in the health care system with potentially less doctors to treat them.
We have to reverse this $1B cut. Then we need to increase the budget to teaching hospitals by at least another $2-3B. Maybe more. Residency programs are a huge part in training doctors. Making sure the program is well funded is vital to training good doctors. If we increase residency capacity, we would hopefully see our Medical Schools increase student enrollment to match this increase in demand. Enrollment in medical school has remained a constant of 67,000 for nearly 20 years, despite a rising demand for healthcare. A large barrier to Medical School is cost and affordability. If we provided a 20k grant to students in Medical School, it would only cost 1.36B yearly. But, it would hopefully drive up enrollment, while decreasing student debt by around 80-100k per doctor. Also, we should train more Nurse Practitioners. Nurse Practitioners are a fantastic way to alleviating the shortage of doctors while decreasing labor costs. Nurse practitioners are nurses who are qualified to see and treat patients under the "supervision" of a doctor. Nurse practitioners are often former nurses with years of experience in the field who want to practice medicine. N.P.s could see patients for routine checkups and minor to moderate medical issues. This decreases the cost of every day healthcare, increases the capacity of the system, and would direct the more well paid doctors to more critical health services. More doctors and N.P's would eliminate doctor shortages and decrease salaries via competition. It would also increase the capacity of our health care system to provide better care in low income rural areas, and take on millions of uninsured Americans.