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In light of the election, America is united in not knowing what lies ahead. This doctor uses this time to reflect on our health system and its many issues.
America is united in its belief that we do not know what the next four years will bring under a Trump presidency. By all reports, he is a results-oriented kind of guy with no legislative experience. What this means for the Affordable Care Act is anyone's guess. The majority of Americans enjoy parts of the bill and decry others. There are popular parts (like extending insurance for adult children) and unpopular parts (a personal mandate for all). There is no doubt we have learned a lot through trial and error over the last few years and many lessons are ahead of us.
Trump is a capitalist and has thrived under this model. It is no surprise that he continues to advocate for a system that brought him personal success. However, our country is full of citizens for whom capitalism has not resulted in a better life or achievement of the American dream. For almost any topic we are discussing, healthcare seems to play a part. Corporate tax breaks are seen as necessary, in part, because businesses currently wrestle with the leviathan of healthcare coverage for employees. Healthcare benefits and services available to or extended to illegal immigrants are seen as compassion by some and an abuse of resources by others.
International affairs is marked by differences in healthcare outcomes between the United States, which far exceeds health care spending compared with other countries, and other nations. In this country, we pay more for pharmaceuticals than in most, if not all, other parts of the world. Gun control is a healthcare issue since it intersects with accidental death, homicide, suicide, and mental health issues. Racial tensions highlight the broad social implications of poverty and lack of education. Within healthcare, we should be ashamed of the continued health care disparities among races. Gay marriage is seen as important for many reasons, but pragmatically, health insurance is often tied to your spouse, which discriminates against those without a legal spouse.
There is no easy answer - healthcare is a complex problem. There are pros and cons to many proposed solutions. However, as a once-ardent opponent of universal health care coverage, I have come to the conclusion that universal coverage, provided by the government, is our best option. Much like Winston Churchill's conclusion that "democracy is the worst form of government except for all those others that have been tried." We've spent the last three decades proving that, while universal health care may be imperfect and flawed, it is likely better than everything else we've tried.
I am not a political scientist, economist, or policy wonk, but I see healthcare up close and have a chance to informally survey its customers and users at least twenty times a day. As long as healthcare coverage is tied to your marital status, employment status, or poverty, the way our country pays for and provides healthcare to its citizenry will infiltrate every other area of our lives. Universal health care's time is now and the Republican Party has a unique opportunity to free our country from the shackles of bloated, ineffective healthcare spending so that we can focus on other issues.