The 2024 Health Debate: Piecemeal Fixes Won’t Heal the System

The rising cost of health care is also a major concern for voters in the 2024 election. Although members of both parties agree that the costs are too high and have discussed these problems during the presidential debates and the vice president, the candidates did not specify their plans to deal with them.

Former President Trump was heavily challenged for saying he had “ideas for a plan” to fix health care. That said, neither Trump nor Vice President Harris has offered detailed proposals to address the core public health problems that would require administration change. Despite their different political leanings, both candidates’ policies focus on symptoms of the health crisis, such as drug prices and insurance coverage, without talking about a broken system. of the health care business.

The health care system is failing not only because we invest heavily in it without getting equal value, but because the entire structure—how care is delivered, paid for, and promoted—is unsustainable.

The Harris-Walz proposal aims to expand the government’s safety net and create new regulations that could distort market forces. Harris wants to build on Biden-era legislation like the American Savings Act and the Affordable Care Act, which extend ACA eligibility and subsidies until 2025. He also wants more regulation of drug prices. As I wrote in a recent column, Vice President Harris intends to extend important provisions of the Affordable Care Act beyond Medicare recipients. His plan would increase the $35 monthly cost of insulin and the $2,000 annual cap on out-of-pocket drug costs, currently available to adults, to all Americans.

The Trump-Vance ticket, while taking steps toward market-based reforms like price transparency, ultimately falls short of addressing deep, structural problems within health care, such as by their opponents, they are only adjunct solutions to a system that needs basic help. change. During his first term in office, president Trump introduced price transparency requirements for health care providers, which sought to make health care prices accessible and understandable to consumers. The health care delivery sector successfully resisted this effort even after the Supreme Court’s decision upholding the law. JD Vance emphasized the importance of this issue during the Vice President’s debate, saying that in health care, “price transparency will give American consumers less choice, and it will lower costs.”

As president, Trump tried to implement price controls, proposing to reduce drug prices based on the lowest price paid in other countries, called the Most Favored Nation model. Although the plan was ultimately rejected in court, the Trump campaign has not taken a firm stand on how it will deal with drug prices if elected for a second term. The cost of medicine seems to be a concern for both, and as I have written elsewhere it will require a joint solution, not frequent band-aids aimed at one part of the market.

Finally, small solutions from both sides will not provide what the patient-consumer needs: better health outcomes at lower costs of care. No group is looking through a wide enough lens. Therefore, the proposed solutions fail to address the root causes.

The fundamental problems of health care cannot be solved from the sidelines – in fact, changing one law at a time without understanding how the components fit together. CMS has been trying to bend the cost curve without success for more than 30 years; prices have continued to rise as results have decreased, and satisfaction has decreased. More integrated solutions—addressing problems from across the political spectrum—remain elusive, leaving us with short-term fixes that have added complexity and cost to a highly complex, expensive, and opaque system. .

As I have explained elsewhere, politicians from both sides of the aisle should focus on the total cost of health care, including regulatory costs, transparency and quality outcomes rather than adjust the cost of prescription drug prices or insurance coverage in one place. . Both are symptoms of a broader problem—a health care model corrupted by inappropriate incentives. Piecemeal solutions act as a barrier to solving the underlying problem.

In the current system, health care delivery, payers (traditional insurers, employers, and government), pharma, medical device companies and consumers—every sector of the industry— they are not encouraged to consider, much less adopt, a new market-based model. , in which payment is linked to important outcomes. But this is the model that consumers need. If the next administration intends to change the health care industry for the better, it must prepare recommendations on cost and quality transparency, accountability for care delivery across the continuum, and policies that promote competition for customers / employers according to important results.

Price transparency, which Trump and Vance have embraced, and Harris and Walz should support, is what enables consumers and patients to make informed decisions about their health care, as they do in other areas of their lives. We look forward to comparing our options when we buy a new computer or sign up for an exercise class. We ask whether the product or service we are buying is worth the cost compared to its competitors. Going forward, new organizations need to create valuable data-driven accounts that describe their services and answer the question, ‘Why should I go to ‘x’ for my services? health?’

If the goal is to make American health care more accessible and affordable, the next Presidential ticket must implement a market-based reform approach: transparency, accountability, and competition to produce important results.