Post-election: The Future of Healthcare

It is the morning after the election and President Elect Donald Trump has shocked pundits and pollsters by winning the majority of the electoral colleges and becoming the 45th President of the United States. Among his many suggestions for actions he will take, he has promised “on day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.” In my discussions with healthcare leaders last week, this promise has the industry worried. While I think all would acknowledge that the current system has problems, the notion of repealing the Affordable Care Act (ACA) without details of what might replace it has left most fearing the uncertainty.

As I lay wide awake at 3 a.m. trying to come to terms with the election results, I thought about what might happen to healthcare. Here are a few of the thoughts that came to me.

First, we know that 20 million people have gained health insurance through the ACA. As inconceivable as the election outcome was to me, it is even more inconceivable that politicians would allow all of these people to be dropped from insurance. There has to be some system that replaces the ACA to allow these millions of voters to maintain health insurance.

Second, we know that even with the ACA, healthcare costs are skyrocketing. The U.S. spends far more per capita on healthcare than any other nation in the world. The total cost of healthcare for a family of four is more than $23,000 and the average household will spend close to $10,000 this year on out-of-pocket expenses. With health care premiums seeing double digit growth and wages growing at less than 3 percent, this is a train heading off the tracks. Regardless of whether or not the ACA is repealed, something must be done to control costs.

Third, the combination of skyrocketing costs, baby boomers retiring, and people living longer, means that Medicare must be changed. More than 50 million people currently receive Medicare benefits. That is a lot of voters. What will a Trump administration and Republican congress do to maintain the solvency of Medicare without disenfranchising all of these voters? Your guess is as good as mine, but we know they will have to do something.

It is a new day. The sun rose again. Healthcare will continue to challenge politicians in power. And I am hoping for a better night sleep tonight!