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Is this the right time for health care reform?

Health Care Reform and Policy
by Cabe Chadick
Is this the right time for health care reform?
Is this the right time for health care reform?

With tens of millions of workers across the country losing their jobs - and with them, the health insurance that often covers multiple members of their family - there are legitimate concerns at the highest levels of government about how health care reform may be able to address these issues. However, the changes that might be needed to ensure no one slips through the cracks would likely be slow to implement and potentially wouldn't measure up to the current situation.

Experts also aren't certain that using the novel coronavirus pandemic as a jumping-off point for broader health care reform is necessarily a good idea, and certainly those changes won't even get under way until at least 2021. General Surgery News notes that "health care reform" is a fairly broad umbrella under which a number of pressing issues fall, everything from broadening insurance options for workers, the cost of medications (and issues with the supply chain that have cropped up in recent months), increasing access to care and more.

It's worth noting that the U.S. is likely months - or even years - away from reaching a point when health care will return to normal, so trying to make changes now might also put into place standards that are almost instantly obsolete. That may be particularly true because so many care providers have suspended certain types of treatments, such as elective procedures; as a result, there may be a new wave of health care costs waiting to crest.

Is the American health care system fully prepared for a post-COVID reality?Is the American health care system fully prepared for a post-COVID reality?

How does the public feel?
For years, Americans have expressed some level of growing dissatisfaction with the status quo, even as many say they're content with their own individual situations. Despite the present conditions amid the pandemic, it seems that attitudes aren't changing that much, either, according to a recent poll from The Associated Press. While slightly more people (54%, up from 52% in February, before the pandemic really gripped the U.S.) believe the government would do a better job of reducing costs in the health care system, fewer are confident the public organizations or agencies could provide better health insurance than the private sector, or improve the quality of care.

There was also data to suggest that despite the mounting job losses, people were generally less worried about how the pandemic would affect their health care, the report said. Just 19% said they were extremely or very concerned about losing coverage, down sharply from the 28% three months earlier. Further, just 35% were concerned about the cost of care, and 46% were worried about access to treatments. Both those numbers were down by similar percentages over the same period. The reason for that may be a simple, pandemic-induced shift in perspective - though that might not be an indicator that everything is going well.

"In February, people had all sorts of complaints about their jobs - their daily tasks, their hourly pay," one respondent told pollsters. "Come May, there wasn't a whole lot of complaining. It was, 'I'm happy to be here, and I'm happy to have a job.'"

Different impacts
Of course, not all states have been affected by the pandemic in the same ways, just as they have all taken their own approaches to health care reform under the strictures of federal rules and regulations. In Vermont, for instance, experts see their efforts coming under a microscope specifically because of the pandemic, according to Burlington television station WCAX. In some ways, a transition to an all-payer system in the state has been a boon, especially for smaller care providers who receive flat reimbursements from both public and private insurers regardless of whether they have suspended or reinstated elective procedures.

However, such a system may require the state to change or even suspend use of this year's reporting requirements to determine how effective the state-level reforms have been. There is an acknowledgement in both the state government and from private health care leaders that even an all-payer model won't work as fully intended without full buy-in from the sector, and in the meantime, many are facing difficult financial times because voluntary treatments have largely been suspended.

The big picture
As the situation continues to unfold for individual states and the nation as a whole, there's a growing feeling within the medical community that broad, comprehensive health care reform is certainly coming down the pike. A recent article published in the New England Journal of Medicine on the many issues that existed before the economic downturn noted that the pandemic has laid bare the strengths and weaknesses of the system as it stands. It further stated that while changes to the current U.S. health care system may not be possible in the near future, they remain necessary.

For all these reasons and more, health care providers and insurers may need to do more to make themselves responsive to the changing times and provide as much clarity as possible for their patients and policyholders.



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