ACA, AHCA, and California’s Single Payer System

By Senator Steven Thayn

The American health care system started developing three basic flaws beginning shortly after the end of WWII: a focus on health insurance, employers began to pay more of the costs creating a third party-payer system, and health insurance no longer was a risk management tool but became a pre-paid medical system.

The net effect disempowered the American people and transferred power and control over resources and how those resources were used to insurance companies and the federal government. Health care became about funding institutions rather than fostering relationships between patients and providers and respecting personal choice. It is time to re-empower the people.

The Affordable Care Act did not address any of these flaws. It gave more power to insurance companies and Medicare and Medicaid. The ACA further strengthened the third party-payer system. The ACA enhanced the pre-paid medical scheme Americans have become accustomed. The ACA was about providing health insurance to everyone thinking that health insurance equated to access to health care.

The Affordable Care Act did not bring down medical costs; rather medical costs increased with many people losing their previous health insurance product. The American Health Care Act (AHCA) has the same flaws. Recently, California has suggested a state-run single-payer system. It also has the same flaws as the ACA and AHCA. Costs will not decrease nor will access increase or outcomes improve.

The ACA, AHCA, and the Cal-system all suffer from the same flaws. They all are insurance focused. None of the three plans empowers the people.

The ACA, AHCA, and the Cal-system all provide services to the masses of people and treat people as a cog in a big system; a system that spews out non-personalized, standardized services. The ACA, AHCA, and the Cal-system all fund institutions. They are not patient centered. The patients are become passive recipients of medical services with little voice. Insurance companies, large hospital administrators, and Medicaid and Medicare bureaucracies make the decisions.

This is a problem because 87 percent of all medical care is for the treatment of chronic illness and 75 percent of these chronic illnesses can be eliminated or greatly improved by 4 lifestyle choices (smoking, overeating, lack of exercise, and stress). Unless the people are active participants in their own health people will not make the necessary lifestyle changes and, medical costs cannot be significantly reduced. The ACA, AHCA, and Cal-systems all suffer from the same flaw in design. They do not empower patients or providers

Second, primary care is not the focus of any of the three proposals. Yet, it is primary care where relationships are formed and patient health can be greatly impacted at a low costs. Health care in the US needs to rediscover the power of primary care. The ACA, AHCA, and Cal-system all miss the mark on this important issue.

Third, funds under the ACA, AHCA, and Cal-system are allocated to medical systems; not to people. The control of funds gives power to make decisions to the institutions that control the money. The people under all three systems are not empowered with any of the funds. Funds are denied them to access the medical system as they see fit. Lack of funds in the hands of the people will perpetuate a passive access of medical care and not encourage good health choices.

In short, the ACA, ACHA, and the Cal-system will all fail to meet the objectives of empower the people, reduce costs, improve outcomes, and increase medical access.

I have written a book called “Reclaiming Health Care” which lays out a blueprint for reforming the medical system which can be obtained by responding to this email. There are 5 areas of need:

  1. Focus on primary care

  2. Change the way primary care is funded