President-elect Donald Trump will enter office in January facing several tough issues. None bigger than what to do with the monstrosity that is the 2700 plus page Patient Protection and Affordable Care Act ("ACA" or ObamaCare").
While we squabble over how to repeal, replace, or even just amend Obamacare, a pink elephant sits not so quietly in the room. Obamacare's core premise has failed. While more Americans are covered, health insurance is far from affordable, and taxpayers are fronting the bill. The next step down this line is a massive single payer system. Would the return on this type of giant investment be worth it?
Leaders from both parties have historically attempted to cure the nation's health care ills with big solutions. Starting in 1965, when President Lyndon B. Johnson first went big into government run health care with Medicare and Medicaid. At the outset, Medicaid was only to cover people getting cash assistance. Today, a much larger group is covered, amounting to 70 million people, over 20 percent of our nation's population.
In the 2003, President George W. Bush doubled down on more government involvement in our seniors' care with the passage of Medicare Part D and its unprecedented entitlement of prescription drug benefits.
The results? More Americans get their health care coverage from these two programs than any other source. Also, more Americans complain about the care and coverage they receive from these two programs than at any other time in their history. And, oh yes, while mostly absent from this year's debate, Medicare and Medicaid both sit on the not so distant verge of insolvency.
Then there is Obamacare. The big government solution now almost universally viewed as a complete failure. Just ask President Bill Clinton, who once called it the "craziest thing in the world." Ironically, he too attempted to pass a gigantic nationalized health care program in the 90's.
So how does Trump win with "Trumpcare"? Simply put: he goes small and cost-effective. With the goal in mind of helping more Americans in need of treatment get access to variety of options, he can scale individual expectations to levels of care and coverage.