I find myself in London, England, on November 2, 2010, for a week of business in two European nations that extend universal health care to their citizens: the UK and Denmark.

The Hill’s Healthwatch blog writes today that, “House Republicans will bring early vote on repeal of health reform.” Haley Barbour, head of the Republican Governors Association, exclaimed, “I think if [Republicans] don’t fully repeal and replace it, they will make such big changes in it over the next three years that you won’t recognize it.”

Here in the UK, the Guardian newspaper published a column opining that, “At a macro level, US healthcare is mediocre overall, according to many measures, and cripplingly expensive. But most Americans don’t know that. So it takes time to persuade them that big changes are needed, and Obama and the Democrats didn’t take that time. They pushed when Americans were angry at bankers, not insurers.”

Health Populi’s Hot Points: As I knew I’d be overseas for today’s election, I voted via absentee ballot two weeks ago in the state of Pennsylvania. Notwithstanding the fact that the state is home to six medical schools, there’s currently a primary care physician shortage which, if the status quo remains, is projected to get much worse in the next two decades. More than 1 in 10 Pennsylvanians under 65 are uninsured (which is better than the national average of 18% – closer to 1 in 5). And, nationally, over one-half of Americans have done something to self-ration health care due to costs, from splitting prescription medications to delaying physician-recommended preventive care and diagnostic tests. 

The Affordable Care Act seeks to increase the supply of primary care, pay for prevention and move toward paying for quality, not paying for volume.

These aren’t impeachable offenses: they are components of a high-performing health system. Without meaning to do so, the Republicans could usher in a world of hurt (and ultimately, a single payer health system) by not attending to these building blocks for an economically healthy health system.

1 Comment on Impeaching health reform: reflections on the night before 2010 mid-term election results

BR said : Guest Report 11 years ago

You mention a shortage of primary care and the need to increase those numbers. The real shame is the greater knowledge loss of specialists leaving healthcare. Not only due to the majority moving into retirement and the decreased payments from Medicare to preform best in class-world class care but also because there are far fewer numbers going into specialties due to a far greater risk due to lower salary, increased litigation liability, cost in performing cutting edge tests and therapy. Just what they needed after 13+ years of higher education and serious personal debt. The healthcare bill could have addressed these things at the root cause. This is something we need to get right. It's very wrong.

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