Although, Americas spend more for medical and health care, and prescription drugs, than most of the rest, of the world, it still can, and must, be improved. Is the finest quality care, a privilege for the elite, or, should it be a right, guaranteed to all, regardless of income, and / or, socioeconomic ability, etc? In President Obama's second – term, the ground – breaking, Affordable Care Act, was passed. Although, it was a step, in the right direction, especially when it came to covering pre-existing conditions, and being able to cover children, up to age, 29, it was also, a seriously flawed document. It became a partisan issue, where members of the Republican Party, spent almost a decade, trying to repeal it, but. unfortunately, offering no viable solutions, and / or, alternatives, to meet our health needs. With that in mind, this article will attempt to, briefly, consider, examine, review, and discuss the relevant issues, needs, concerns, and realities, of improving the level of health care delivery.

1. Issues: The primary issue to consider, is determining the priorities of the United States. We have witnessed, for the past two years, what appears to be, a concerted effort to create a political division, by attacking the flaws, without making any appropriate attempt to improve it. President Trump has issued Executive Orders, and used other political techniques, to mitigate the ACA, while using empty rhetoric, and promoting great care. Since he has held office, costs have increased, deductibles and co-pays have risen, prescription drugs remain high (and are rising), and those with pre-existing conditions, have felt threatened, with losing their coverage. With the upcoming Presidential election, less than 2 years away, potential candidates, seem to be positioning themselves, to offer what I believe, are, pie – in – the – sky, less than fully considered ideas, for medical and health care, etc . While this President, often, attacks Obamacare, and promises something great, he has offered no details, towards a viable solution. The Democratic candidates have jumped on the Medicare For All bandwagon, often glossing – over the obstacles (financial, practical, treatment, etc), to achieving this. There is far too little discussion about the cost of prescription drugs (we pay more than the rest of the world), and hospitalization, etc. We have heard, almost nothing, about the impact, of ever – rising malpractice insurance costs, and the need to control these.

2. Needs: Does not it make sense, to have a system, which provides the highest quality care, for all, regardless of personal financial ability, at the most reasonable costs? Should not we base our system on what's best for patients, instead of insurance companies, etc? How can we achieve the finest objectives, in a pragmatic, but idealistic manner?

3. Concerns: We should all, be concerned, that, partisan politics, has controlled, what we should, and need, to do!

4. Realities: While it may sound good, to some, to seek Medicare For All, we have not received any real financial financial, to examine, if this is what might be best, for us. The existing, Medicare, covers individuals over 65, who have, predominately, paid a payroll tax, their own life, to cover much of the cost, Once 65, we must continue to pay, a little more than $ 1,600 per year. This provides a system, which pays 80% of the so-called, Part B (doctors) component, Medicare schedule, but does not cover prescription drugs, etc. Since many realize, they can not handle the 20% responsibility, they purchase a supplementary insurance policy. The most popular, inclusive plan, previously costs an additional, more than $ 300, per week. Therefore, when you add the $ 1,600 (Medicare premium), to the supplement's cost of over $ 3,600, per year, to the lifetime, payroll deductions, it's apparent there are financial limitations! In addition, while doctors might be willing to accept the reduced Medicare payments, from a limited percentage of their overall patient populations, is it realistic to expect, them, to be willing to accept, this, from all?

America needs the finest combination of quality health care, reasonable costs for treatment, and prescriptions, and the best, possible system! Wake up, America, and demand, your elected officials, do what's needed and necessary, rather than merely, expedient!