A year ago, it would have been hard to predict how much of an impact the first year of the Trump administration would have on healthcare policy. Physicians Practice wrote in October of 2016: "After being of primary importance in 2012, healthcare is almost an afterthought in the 2016 election."
After being the top issue for the 2012 campaign, Gallup ranked healthcare the fourth most important issue for Republicans, third for Democrats. "I don't think healthcare has been discussed much; there has been some talk on what could be done with the Affordable Care Act," Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, told Physicians Practice last year.
Instead, health policy was thrust into the spotlight for the first six months under the Trump administration. Republican congressmen and influential members of Trump's Cabinet, including Vice President Mike Pence and HHS Secretary Tom Price, MD, as well as the president himself, were all engaged in months-long efforts to repeal and replace the Affordable Care Act (ACA).
How has the Trump administration done thus far on healthcare policy? Not great, according to the respondents to the Physicians Practice 2017 Great American Physician Survey. When asked to grade his administration on healthcare policy thus far, 40.4 percent said the administration deserved an “F” — the most popular grade percentage by far; 20.53 percent said the administration deserved a “C”; 18.4 percent gave it a “B”; 11.6 percent gave it an D; and only 9.07 percent gave it an A.
We spoke to physicians across the country— from those who say leadership in Washington, D.C., has failed thus far, to one doc who gave Trump an A.
Carolyn Eaton, MD, a family physician in San Antonio, can't separate Trump, the man who campaigned for president, and Trump, the president who oversees an administration. The reason she gave Trump and his administration an “F” on healthcare comes down to one basic reason. "On the campaign trail, [Trump] would go on about having a great healthcare plan…he out-politicked the politicians is what he did. He figured someone else would figure this out later. And so of course he had nothing and presented nothing. That's a failure; don't promise what you don't have," Eaton says.
While some can separate Trump from Congress, Eaton places the blame on both. She was unimpressed with their efforts to repeal and replace the ACA. She says it was a huge step back and would have resulted in 8 million people losing insurance. She defends high-deductible plans and says they are better than no insurance at all, which would have been the case under the Republican plan. Instead, she says she'd like to see bipartisan efforts to fix the ACA, but says Trump put the kibosh on that.
One positive she has seen from the Trump administration, due to the failed efforts to repeal the ACA, is more physicians accepting and advocating for universal healthcare. A recent survey from Merritt Hawkins confirmed this, indicating that 56 percent of doctors were found to support a single-payer system. Eaton would rather deal with one set of rules, such as that under the “Medicare for all” plan, than 18 sets of rules, which she deals with through government and commercial payers.