Last night, the Democratic candidates for President gathered in Ohio to participate in another round of debates. Per usual, the central topic related to healthcare was the fight over which plan to provide universal healthcare coverage was the best. Each of the candidates stuck firm to their initial plans, whether it was Bernie Sanders and Elizabeth Warren rallying for Medicare for All, while others outcried for Medicare for All that Want It, and Joe Biden supported expanding the pubic option and building upon the Affordable Care Act. Senator Warren took many shots about how her plan would be funded, with Joe Biden referring to her as “vague” and Mayor Buttigieg claiming that Senator Warren was asked “a yes-or-no question that didn’t get a yes-or-no answer.”
Although this has been a familiar theme in previous presidential debates, last night’s tussle included some inclusion of other healthcare topics that hadn’t been discussed before. Amy Klobuchar brought up the opioid epidemic and all of the candidates agreed that pharmaceutical companies should be responsible for paying for rehabilitation and treatment programs. Some candidates even pushed for executives for these companies should be held criminally liable and locked up in jail. The other healthcare topic was women’s reproductive rights, a big issue being talked about lately with new state legislations in Ohio and Alabama, significantly limiting the access to abortion and reproductive services. All candidates vowed to codify Roe v. Wade and fight for access, which will disproportionately impact low income and minorities, per Cory Booker. Neither of these topics was very controversial among the candidates, but will be important issues as the Presidential General Election nears.
The real thing that caught my eye was the lack of conversation around the actual business of healthcare. Solving the coverage problem is only one piece of the problem. You cannot have a successful system without considering cost, quality and access - none more important than the others. Insurance coverage does not ensure access to care. Humana released a new study this week, showing that 25% of total healthcare spending is due to waste and administrative burden. Something must be done to get these numbers down. There also has been no mention of how to expand services to rural areas among the ongoing physician shortage or the increased use of technology used in healthcare delivery.
Today, we attended a presentation where Healthcare Leaders of San Antonio discussed the current economic state of the country and healthcare reform. The overwhelming majority of the presentation spoke about the current debt of the nation and the impact that current programs will have in increasing these projections - the numbers are astronomical. My parents have always joked that it would be up to my generation to deal with this problem, and today, after this presentation, I realized just how daunting that task would be. As all new healthcare, and even programs outside of healthcare, are suggested and pitched throughout these debates, we must consider the cost to our nation and its long-term economic impact. No one wants to cut current programs or increase taxes to pay for programs, so a compromise must be struck somewhere. Let’s just hope someone in my generation has the answer before it’s too late.