Doctors interviewed on NPR offered their opinions on what works and what doesn't in U.S. health care, and they have some strong views on the subject.
To kick it off, they're all pretty sure that things are heading in the wrong direction.
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Doctors Julie Gunter, Rob Stone, and Gary Sobelson were asked in the NPR interview not just about the health care system, but also about their opinion of Republican efforts to replace the Affordable Care Act with the Better Care Reconciliation Act, the Senate version of the American Health Care Act.
Stone and Sobelson cite positive effects of the ACA, while Gunter has left the system altogether, launching a cash-based practice which charges patients a fixed amount per month. She says although her patients who have it say Medicare works, those patients who don't — those between ages 30 and 60 — "are dropping off their health plans."
"They tell me, 'I can choose between putting food on the table, paying for my kid to go to college or getting a health plan that I can't afford,'" Gunter adds.
So, Gunter says, "the heart of it, in my opinion, is we talk a lot about who's going to pay for health care. But what we should be talking about is the price of health care."
Both Stone and Sobelson, who favor a Medicare/Medicaid approach to coverage, point to the high cost of care, with Sobelson saying, "We've designed a system that rewards high-reimbursement procedures, surgeries and undervalues the things that are cost-effective."
And while Stone highlights the benefits hospitals in his area have seen from the ACA, particularly from Medicaid expansion, he points to the problem of "copays and deductibles and premiums [that] keep going up for the people who aren't on Medicaid," adding that "people coming into the ER find themselves underinsured too often when they realize they can't afford their copays or their deductibles."
Sobelson says "the high costs are things that the system itself brings about."
"We've designed a system that rewards high-reimbursement procedures, surgeries and undervalues the things that are cost-effective," he says. He adds that one failing of the ACA is "allowing corporate profitability to be the driving force of how" prices for care and procedures are set.
So what about the BCRA? All three have harsh words for the proposed bill, with Stone saying it's "a terrible thing that would set us back and would cost lives. And the people who would be hurt the worst would be children, the disabled, and the elderly and nursing homes because of the ravages to Medicaid."
Sobelson says "the damages to Medicaid that the Senate bill would bring about would be devastating to us and take back so much positive progress we've had in terms of access and cost containment," and Gunter, citing what she says is her favorite quote about health care in the U.S., says, "we continue to tape wings on a car and call it an airplane."
She adds, "[W]e have to radically transform the system at its core if we hope to end up in a different place."
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