Reassessing Trump’s Progress in Health Reform

Most of us — well, those of us on the political Right, anyway — are frustrated with the fact that Obamacare (ACA) has not been completely done away with. When the Senate failed to pass the American Health Care Act of 2017 (AHCA), which would have been at least a partial repeal, the President received at least as much flak for it. In general, the topic is a sore one, and people (along with the MSM) are more than happy to blame Trump for this failure.

But, in a recent opinion piece for Fox News, Newt Gingrich pointed out the following:

“What the media have missed is an administration-wide health reform effort, enhanced by congressional action that will lower costs, increase access and improve health outcomes. Because this new strategy doesn’t fit the news media’s focus, it has been routinely ignored. The diverse nature of the many small steps underway has made it hard for analysts and reporters to understand how important they are.

It has always been a mistake to think the health system can be fixed in one giant step. Health costs are about 18 percent of the U.S. economy, which is the largest economy in the world. Health care is also the most deeply dependent on science and technology of any field of human endeavor. No one is smart enough to fix a system that big and that complex in one giant reform.”

So, absent the likelihood of a sweeping reform bill to address everything, the Trump administration has adopted a many-small-steps approach. Gingrich discusses a few already done or in the works; here’s the short version:

o  FDA Commissioner Scott Gottlieb has introduced significant steps to speed the approval of generic drugs, “mov[ing] away from a “first come-first serve” model…to prioritize the applications of generics that would serve as alternatives to brand-name drugs with fewer than three generic competitors. The FDA is also prioritizing approval for generic alternatives to complex and expensive drugs, as well as streamlining the overall generic drug approval process.”

o  “At the Center for Medicare and Medicaid Services, Administrator Seema Verma has taken additional steps to save consumers money on their co-pays and out-of-pocket costs. Over the objection of the hospital lobby, CMS announced badly needed reforms to the 340B drug discount program…. [S]tudies have shown that in many of the participating hospitals very little of the savings reach poor patients. CMS’s announcement that it would cut the reimbursement rate for those drugs will save taxpayers money, and it will also reduce co-pays for Medicare patients who usually pay a percentage of the price Medicare pays.”

o  “The administration has also taken steps to prevent future price gouging scandals like the infamous Martin Shkreli price hike of an AIDS drug from $13.50 a pill to $750, by identifying the drugs most vulnerable to pricing abuse.”

I have to admit, while I despise such price gouging, I am “nervous” about government intervention even for this sort of thing. I’d like to know more details.

o  Labor Secretary Alexander Acosta “issued proposed rules that would dramatically expand the availability of Association Health Plans. These plans could be national and regional, allowing for the sale of insurance across state lines, but critically still maintain state autonomy in regulating insurance – which will help police against fraud.”

o  “The Trump administration has also allowed insurers to continue offering “grandmothered” plans created prior to ObamaCare, maintaining these lower cost plans for long-time customers. This saved many small businesses and self-employed people a lot of money and anxiety….”

o  “[T]he Trump administration fixed a number of loopholes in the ObamaCare enrollment rules,” which had allowed the ethically-challenged to game the system and drive up prices.

o  “President Trump also made it easier for people to shop for health insurance without using the website.”

I have a dream that one day this website will only be used to explain the market-based, decentralized healthcare system in and across all states and territories of the USA….

o  The continuing resolution that Congress just passed included a nice health reform, too. “[It] suspended the health insurance tax for one year, the device tax for two years, and delayed the Cadillac tax until 2022, all of which were part of ObamaCare. All of these taxes were simply passed on to patients in the form of higher premiums, so each of these steps will save patients money.”

o  Congressional Republicans are working toward bipartisan approval of “additional market stabilization measures [that] could lead to a 15 percent reduction in premiums for 2019 – another big win for the consumer and taxpayer.”

Certainly, there is a lot more to do, and there is more on the way. The all-in-one-fell-swoop idea sounds great, but as Gingrich pointed out, it isn’t always feasible, especially with something this huge, complex, and impactful in so many areas and on multiple levels.

Gingrich concludes:

“The practical reality of developing new and better approaches to health and health care is a key to the general success of the Trump administration. In the long run, the 1,000-step approach of practical reform will prove vastly more effective than either ObamaCare or SandersCare with their focus on sweeping giant government bureaucracies. This progress in health care is one more example of the impressive results of the Trump administration’s first year.”

I was encouraged by reading this summary, and I remain hopeful that the Trump administration, working with a GOP-majority Congress, can eventually get the patient-friendly, market-driven model that we need implemented.


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