No easy answers to health care dilemma

The Republican Congress is learning that it is far easier to criticize than to govern, that it is easier to make promises than to keep them, and that it is problematic building your agenda on an unintelligent base.

I admit that last statement is overly harsh, but polling revealed millions of those who said they want Obamacare repealed also stated they like the Affordable Care Act and want to keep the benefits received from it. Not understanding that they are one and the same cannot be considered highly intelligent.

President Trump and the Congressional GOP are in a bind, as the outrage represented in recent town hall meetings has shown. They are aware their base has demanded a repeal of Obamacare while at the same time wanting its benefits. They are aware, or at least should be, that no industrialized nation has been so heavily burdened by the cost of health care as the United States.

Health care-related costs now account for one in every five dollars of the American economy. The problem for the president and Congress is what to do about it while keeping their promises. It won’t be easy. That this is a complicated issue should be obvious to any intelligent person.

Say what you will about President Obama, but he at least recognized something had to be done. Obama tackled two problems instead of one. Rather than dealing solely with the unaffordability of health care for the average American, he added on the issue of ensuring all Americans were afforded protection against ruinous health care expenses. For decades, the single greatest factor in home foreclosures has been disastrous health care expenses.

Obama chose not to take the path of the rest of the industrialized free world. He opted not to go with a single-payor system. He believed the Republican opposition would be too great, so he adopted a more conservative approach, one originated by Republicans.

Rather than so-called socialized medicine, Obama decided to include the health insurance industry in the solution. Requiring universal coverage was the only way insurance companies could handle the cost of insuring those with high-risk pre-existing conditions.

The GOP refused to cooperate anyway. What Obama and the Democrats failed to realize is that the insurance industry is a near monopoly. They also failed to realize that it would take more than a penalty to ensure healthy young people would purchase coverage. Without the combination of a competitive market and the cooperation of millions of healthy insureds, the ACA could not work.

President Trump claims he has a yet-to-be revealed plan that “would keep everyone insured” and be “much less expensive with lower deductibles.” Unless he can resolve the above issues, he is wrong.

Congressional Republicans lean toward much higher deductible plans under the free-market theory that higher costs will force people to shop aggressively for policies and spend less on health care. If we have only a couple or three choices in carriers, that won’t work.

There is talk that Republicans will let states enroll the uninsured in inexpensive catastrophic policies that Congress expects to pay for via tax credits.

Anyone who has ever dealt with a high-risk insurance pool knows it isn’t going to be inexpensive. Congress might offer federal tax credits to encourage people to buy more comprehensive coverage but require them to absorb some of the cost of increased premiums.

None of these options reduce health care costs. None deal with the fact that we pay far more for medical care than any nation on earth. There can be no resolution until we find the means to change that fact.

Michael Adkins is a former chair of the Hancock County Democratic Party. He lives in Greenfield. Send comments to