Editor’s note: The Ideas Lab asked the Democrat and Republican candidates for the US Senate to submit 1,000-word essays on how they would handle health care, an issue researched by Wisconsinites as part of the Main Street Agenda project. said that this is the third most important problem they face going to the November 5 election.
The Affordable Care Act made many promises that would slow the rise in health care costs and improve access to care. Also, President Obama said you can keep your family doctor. The reality is that health care costs have only skyrocketed since legalization and reduced access to care in every community. The family doctor is all sad but gone. The law looked good in theory and included one reasonable provision, which ensures that individuals with pre-existing conditions can receive health care, but everything else has become more expensive and more expensive. the worse the health care.
Tammy Baldwin says:We beat Big Pharma, but I’m not done fighting for your health care
In my personal and professional life, I have been encouraged to delve into the complexities and complexities of our healthcare system to find solutions. In 1991, I was diagnosed with multiple sclerosis at the age of 27, which changed my life completely. As an entrepreneur, I have started many businesses, bought health insurance for thousands of employees in my work.
A little over 10 years ago, the continued rise in medical costs began to take a toll on my business and my employees. Eventually, I also had to move to my employees’ insurance in an effort to keep the cost of health care down.
The ACA played a major role in increasing costs and decreasing care
It allowed great consolidation between the health systems, creating oligarchies and monopolies. As a result, health systems do not need much to operate efficiently and are not forced to provide a purchase for patients.
I have seen this in my hometown of Madison. Madison’s largest health care provider, UW Health, agreed to buy the second largest, Meriter Health Services. Estimates indicate that the merger now controls nearly 60% of the market for hospital services in the Madison region. Health care management has led to lower quality, higher costs, and reduced access.
This large combination has also caused it to quickly fall in front of the family doctor. The ACA placed many regulations on the family physician, and the integration of health care made it difficult for family physicians to remain in the public insurance pool, which encouraged many doctors retire or sell to big doctors. Health care products typically sell independently, medically tested products, adding to their pricing power.
Another major flaw in the ACA is the bankruptcy rate. The MLR is a financial limit on profits that requires health insurers to spend a minimum percentage of their income on medical care. While this sounds good in theory, the reality is that the law is only forcing the cost of medical care to rise faster.
The reason is that if you are recording what a health insurance policyholder can get on a budget, there is no incentive to pay any more. return medical expenses to increase their profits. In fact, the only way a health insurer can increase their income is to allow medical costs to go up.
Vertical integration has reduced transparency, increasing costs
This has also created direct integration with health care providers that are integrated with health insurers and even to hospital benefits managers, reduced transparency and increased costs. Cigna, United Health, and CVS Aetna all have or are partnering with PBMs, which have allowed them to increase their medical payments to them, passing the higher cost on to patients. Health care costs have risen 20% faster since the MLR began under the ACA than five years ago.
Rising health care costs under the ACA put individuals and families at a financial disadvantage. In 2010, according to KFF, the cost of family insurance was $13,770. In 2023 the cost of family insurance increased to $23,968 – a 74% increase over 13 years. More than 60% of Americans live paycheck to paycheck, which means that a medical bill is only one step away from a financial crisis.
Since 1980, the two areas with the highest cost of living in our economy are health care and higher education. The connection between these two industries has increased the involvement of the government in large sums of money. A lot of money looks good at first, but the truth is that these two businesses continue to raise prices on customers. Especially in health care, from 1980 to 2023, the Medical Care CPI increased by about 445%. That’s amazing.
While rising costs are a major problem, an equally important problem is declining access to care.
As costs rise, access to care in Wisconsin declines
Rural communities across the country and here in Wisconsin are struggling to provide access to care. Last spring, two hospitals in Eau Claire and Chippewa Falls, along with 19 hospitals in western Wisconsin, were forced to close due to a number of factors including record-high costs, poor conditions and accidents. control.
Smaller hospitals are also finding it difficult to deal with more federal regulations and changes in reimbursement rates. The solution of Sen. Baldwin is making things worse by requiring more restrictions and regulations. We need to discuss the reasons behind these closures and limiting access to care.
Our health care system is broken, and it’s important to elect individuals with life experience in the opportunity to provide solutions. As your senator, I will fight for increased transparency of costs in the health system, encouraging patients and employees to shop and make informed decisions. I will fight to require health insurance companies and PBMs to disclose their reimbursement deals and discounts, revealing the true cost of prescription drugs. I will fight to support Community Health Centers to strengthen the opportunity to care for patients in rural areas and cities that are not available. And I will fight to solve the shortage of doctors and increase training programs for new doctors.
ACA looks good in theory, but in practice there are many mistakes. Results matter and Wisconsinites are struggling because of broken health care. We need a radical change to put patients first and prioritize market-based solutions to reduce costs, expand access and increase transparency.
Eric Hovde is the Republican candidate for the US Senate in Wisconsin. He is the CEO of Hovde Properties, a Madison-based real estate company.
Full text of the US Senate health care essay question
Question: Last spring, two hospitals (in Eau Claire and Chippewa Falls) and 19 hospitals were closed in western Wisconsin. The Marshfield Clinic Healthcare System created a job opening earlier this year. In the Milwaukee area, some service providers are downsizing. Health systems cite staffing challenges, inadequate Medicare and Medicaid reimbursements, high costs and declining patient and patient outcomes. private insurance. How do you go about solving this problem?
Question: Health insurance premiums continue to rise by double-digit percentages. Meanwhile, the number of people in Wisconsin who signed up for health insurance through the Affordable Care Act fell to a record high earlier this year. What can be done to make health care affordable for Wisconsin families? From your perspective, what role does the ACA play in this? For example, do you advocate repealing, replacing or reforming the ACA?
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