THE BLOG

Let's Focus on Fixing -- Not Nixing -- Obamacare

06/29/2015 09:05 am ET | Updated Jun 29, 2016

The Supreme Court has sloughed off another major challenge to Obamacare, forcing Republicans to devise a better strategy than their promise to repeal the healthcare law.

Congressional repeal of the Affordable Care Act is an appealing option and would serve as an easy litmus test for the far right. But just because something is simple and grabs headlines (and votes) does not mean it is rational, good for the country or even realistic.

The Congressional Budget Office estimates that repealing Obamacare would increase the deficit by $137 billion over 10 years. Even if this nonpartisan estimate is exaggerated, the barriers to repealing Obamacare are legal, practical and political. Simply put, Congress can't easily change direction on a policy affecting 8 percent of GDP. Politically, Republicans do not have the Senate votes necessary to repeal. And many Americans support parts of Obamacare, including the requirement that insurance companies accept applicants with preexisting conditions.

Yet even the administration admits that parts of Obamacare are not working. A recent report from the Office of the National Coordinator for Health Information Technology found that fewer than three in 10 healthcare providers are able to share electronic health records (EHRs) with outside providers -- despite $28 billion in incentives to transition to EHRs.

Also, the American Medical Association -- the only large group of doctors to support Obamacare -- says doctors complain about looking at screens rather than at patients, and seeing fewer patients because of how time-consuming linear EHR systems are. The current system is cumbersome. Because health records between different specialties do not easily link with each other, many doctors say it's easier to get and share information via printed paper reports. There is a bipartisan desire to fix these problems, as they are hurting both doctors and patients.

Another failure of the current law is the broken promise that patients can continue to see their own doctors. Horror stories abound of patients who can't match up surgeons and hospitals under their current healthcare plans or are forced to stop complex multi-provider treatments because geographic boundaries were not set in the laws. This, too, is fixable.

Another failure is the law's mandate that employers insure all employees, including those working 30 hours a week and interns working more than a few months. Changing the "full-time" definition to 40 hours and requiring interns to work one full year before receiving health insurance would go a long way toward reducing employer angst. At our association, we face a tough decision: cutting back on the number of interns we hire or coughing up $90,000 to obtain health insurance for all our interns.

Now that the Supreme Court has weighed in on Obamacare -- again -- and the law still stands, let's focus on revising and improving the current system rather than digging in our heels against it. Fixing a broken healthcare system offers an opportunity for some easy-but-substantial cost savings in healthcare policy that would save taxpayers billions annually.

Here are a few simple fixes:

  1. Allow Americans to buy their prescription drugs from Canada or other developed countries. Americans pay billions more for drugs simply because the pharmaceutical industry has used political campaign contributions to bar competition and lower prices. This is absurd.
  2. Bar drug companies from giving secret rebates to doctors. If a doctor is paid to prescribe or use a drug, the doctor should reveal that to patients. A Senate Committee on Aging hearing on this practice revealed bipartisan disgust but no action.
  3. Reimburse doctors injecting drugs for each treatment rather than as a percentage of the cost of the drug. Incentivizing doctors to use more expensive medications is a drain on our entitlement spending. For example, most doctors would use the $50 Avastin rather than the $2,000 Lucentis to treat macular degeneration, saving over $1 billion a year for Medicare if they were paid equal amounts per injection and secret drug company payments were barred.
  4. Allow insurance companies to compete across state lines. America was built and thrives on competition. It lowers prices. It results in better service. But under the current system, individuals must purchase insurance in their home states. We can choose to shop for just about any product we want, anywhere we want; why can't the same be true of our health insurance?

Thursday's Supreme Court decision gives Congress the opportunity to take the high ground, fix what's broken and reject crony capitalism. Let's hope they use this opportunity to dramatically improve our health -- both that of the American people and the well-being of our federal bank account.

Gary Shapiro is the president and CEO of the Consumer Electronics Association (CEA)®, the U.S. trade association representing more than 2,000 consumer electronics companies, and the author of the New York Times bestselling books Ninja Innovation: The Ten Killer Strategies of the World's Most Successful Businesses and The Comeback: How Innovation Will Restore the American Dream. His views are his own. Connect with him on Twitter @GaryShapiro.