https://www.theatlantic.com/health/archive/2017/01/price-access/514262/
Why Republicans like HHS nominee Tom Price are emphasizing “universal access” over “universal coverage”
Tag Archives: Universal Access
The Myth of a Cheap Obamacare Replacement
News on the Obamacare-replacement front was dominated this past weekend by Donald Trump and Sen. Rand Paul (R-Ky.), who both touted their Obamacare replacement plans.
To be absolutely precise, they touted the claim that they had Obamacare replacement plans. They didn’t go into any great detail about what would be in those plans. (That didn’t stop CNN from captioning its interview with Paul, “Rand Paul Releases Obamacare Replacement Details.”)
The few details, or guideposts, or guidelines that they did disclose only underscored how difficult it will be for Trump, Paul and the the Republicans on Capitol Hill to fashion a replacement that meets all their stated goals. For Trump, according to an interview with the Washington Post published Sunday, this includes “insurance for everybody” that will encompass “great health care … in a much simplified form. Much less expensive and much better.” He promised “lower numbers, much lower deductibles.”
Paul, speaking on CNN’s Sunday morning “State of the Union” program, said his plan would “insure the most amount of people, give access to the most amount of people, at the least amount of cost.” That sounds like a set of concrete goals, but actually they’re ambiguous. “Most people” compared to what? “Least cost” compared to what?
Before we get into the details, such as they are, we should recognize that if one takes as the goal of healthcare policy to provide universal coverage in which everyone is “beautifully covered,” as Trump promised, then a few limitations immediately appear. Health coverage is the product of three factors: How many people are covered; the benefits provided; and the cost of those benefits. Since the 1940s, U.S. politicians and policymakers have tried to find a balance among these factors. Every effort has been confounded by the immutable facts that treating the sick costs money and treating more people costs more money. One can save money by treating fewer people, or giving the same number of people less treatment. So any politician who says he can do more for less money is almost certainly blowing smoke.
How do the Trump and Paul “details” stack up?
Universal Access And Delegation To States: Examining Two Currents In ACA Replacement Plans
As we draw nearer to the time when the Trump administration may unveil its proposals for reforming the Affordable Care Act and the Republicans in Congress may coalesce around a single repeal and replace proposal, two ideas are surfacing that should be addressed and explored—setting a goal of “universal access” rather than “universal coverage” and shifting responsibility for ACA replacement to the states. This post looks at the challenges involved in operationalizing these concepts.
HENRY KOTULA 