Reflections from a Hospital Bed: The State of American Healthcare
TL/DR –
The author highlights the importance of affordable healthcare, referencing their personal experience with exceptional healthcare facilities and staff. They outline the historical efforts of U.S. presidents to improve healthcare availability, from Truman’s legislative successes, Johnson’s establishment of Medicaid and Medicare, to Obama’s Affordable Care Act that insured millions and reduced the budget deficit. They critique Trump’s efforts to dismantle the ACA through changes in rules and high-deductible plans, which they argue have resulted in declining enrollee numbers and higher costs for consumers and states.
Reflecting on US Healthcare from an ICU Bed
Initial drafts of this piece were written from the intensive care unit at UPMC hospital in Pittsburgh, as age makes health treatments increasingly challenging. Luckily, with affordable healthcare, excellent local medical facilities, and highly competent medical staff, recovery is on the way.
This period of contemplation highlighted the paradox that many in the United States – the world’s wealthiest nation – lack affordable healthcare. Worse, the current government has been striving to keep them from gaining access.
Historically, US presidents from both sides of the political divide have aimed to make healthcare accessible. Harry Truman spoke of his administration’s failure to establish national healthcare but managed to pass beneficial legislation. Lyndon Johnson enacted Medicaid and Medicare — historic steps in health coverage. Richard Nixon broadened this scope and proposed a cap on catastrophic healthcare costs, though this was halted by the Watergate scandal.
Barack Obama, in 2010, led Congress to approve comprehensive healthcare reforms, ensuring coverage for nearly 24 million more Americans by 2016. This plan, known as the Affordable Care Act (ACA) or Obamacare, reduced costs, expanded coverage, ended the disqualification of pre-existing conditions, and covered children up to the age of 26, while also shrinking the budget deficit.
Despite the monumental benefits of ACA, Donald Trump has persistently targeted it, attempting to dismantle it in 2017. Even after being thwarted by Republican Senator John McCain’s famous “thumbs-down” vote, Trump has continued his covert attempts.
Unable to abolish the popular program outright, Trump has resorted to a “death by a thousand cuts” approach, altering the rules of the ACA. High-deductible plans with low monthly payments, a ploy that becomes unaffordable at the point of medical crisis, have caused enrollees to decline from 22.3 million last year to a projected 16.5 million this year.
According to Michael Hiltzik’s recent LA Times column, a further decline is anticipated due to another new rule for 2027. This rule is expected to undermine program integrity, abolish key consumer protections, and burden states with increased costs.
Despite the setbacks, it’s crucial to remember Harry Truman’s words in 1947: “Healthy citizens constitute our greatest natural resource. As a nation, we should strive to make good health equally available to all citizens.” So why does a fear of making American healthcare more accessible, affordable, and humane persist? That remains a puzzling question.
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