Although, politically controversial, the American health care system, should, and must be improved, in terms of both, pricing, as well as effectiveness/ delivery! When the Affordable Care Act, was finally signed into law, by President Obama, in 2010, because, there were far too many uninsured, and/ or, under – insured Americans. However, perhaps because of the realities of politics, this legislation was flawed, and, although, costs may not have gone up, as much as they might have, otherwise, they have seemed to spiral, upward. Instead of addressing the flaws, the Republican legislators, focused on them, for apparent, political advantage. Instead of tweaking it, or introducing ideas, to make it better, and less expensive, they merely, tried to repeal it, but with nothing, better, or viable, to improve and enhance it! When Donald Trump was elected, President, in November 2016, one of his campaign promises, was, he would immediately, repeal and replace, it, with something, far better, and less expensive. Although, the majority of both houses of Congress, were also, Republican, they, neither, were able to repeal, or improve the concept, but, continued to articulate, lots of empty promises and rhetoric! With that in mind, this article will attempt to, briefly, consider, examine, review, and discuss, some potential, viable solutions, to address the needs, and priorities, of the citizens, who need it, the most.

1. Coverage, without pre – existing conditions: Before the Affordable Care Act, those with pre – existing conditions, who, often, need coverage, most of all, could not receive coverage. However, in doing so, healthier people needed to pay slightly more, to subsidize these individuals. Although, President Trump, continues to articulate a message, promising to protect these people, the actions, of the Republicans, in Congress, and his apparent efforts, appeared to contradict his rhetoric. How, to cover these conditions, while controlling costs, must be, a central component of our health care system!

2. Prescription costs: Why are so many, prescription drugs, in the United States, so much more expensive, than the identical pharmaceuticals, elsewhere, in the world? If ever, there is a place, where proactive, governing, is needed, it is, in negotiating, effectively, with these manufacturers, to control this. If, legislators, and politicians, truly, wanted to control this, they would pass a law, where prescription drug prices, had to be priced here, at a competitive level, with the rest of the world.It seems obvious, drug companies, will not, do so, voluntarily!

3. Hospital costs: One of the key factors, which have driven health costs, up, significantly, is the cost, for hospital care. A well – considered plan, focused on an improved, operational model, might have to include, the need for devising a plan, to control the runaway malpractice insurance rates. This has been a political football, because of the power of the American Bar Association, which seems to try to protects its members, by fighting these controls, out of a large degree of personal/ political agenda, and/ or, self – interest!

4. Controlling health insurance costs: Health insurance rates, have been rising, on a constant basis, and, because, the cronies of President Trump, have eliminated the mandate, to purchase insurance, etc, the result has been, the youngest and healthiest Americans, have often, opted – out. The impact of this, has been, increased rates and costs. Some politicians have promised and promoted, what they refer to, either as Universal Health Care, or Medicare for All, while ignoring, some of the factors, which would need to be considered, or factored – in. For example, there are issues, with the original, Medicare, including, the costs, paying into this (all our working lives), the continuous, ongoing co – payments (presently about $135 per month), and the fact, it doesn’t cover, everything (in fact, it covers about 80%). Individuals must purchase supplemental insurance, if they wish to be covered, and the most popular, of these, now costs, approximately, $4,000, per year, per person. Although, many physicians, are willing to accept, the lower payment schedule, because it only represents a portion of their patients, there is, some question, whether a large, enough, number, would accept this, for their entire practice.

5. Use Universal Insurance, to compete: If the Medicare for All, approach, were implemented, what would happen, to the insurance companies, and their hundreds of thousands of employees? Recently, the public has been informed, of the financial weaknesses, the program faces! If this public option, was a component, and/ or, option, it might increase competition, and if, the politicians, focused on doing the right thing, and what’s needed, and necessary, instead of, politically expedient, the system might, actually, improve!

Wake up, America, and demand, your public officials, focus on realities, and viable solutions, instead of, merely, using lip – service, empty promises, and rhetoric! Fixing this, in a quality way, will require, fully considering the options and alternatives, thinking, outside – the – box, and making some tough, but necessary decisions!