America Must Address Health Care Crisis with Comprehensive Reform

The United States faces a significant health care crisis that demands urgent attention. As the nation grapples with soaring health care costs and subpar health outcomes compared to other developed countries, experts argue that the time has come for a serious examination of health insurance reform. Currently, there is no comprehensive solution on the table from either major political party.

Since its enactment in January 2014, the Affordable Care Act (ACA) has successfully reduced the number of uninsured Americans by 24 million, lowering the percentage of uninsured from 16% to 8%. Despite this achievement, the ACA has not effectively controlled costs, leading to record profits for health insurance companies. In 2025, the government is expected to pay around $138 billion in subsidies to these companies, which have seen their stock prices surge. For instance, the stock values of UnitedHealth Group and Anthem have more than quadrupled since the ACA’s implementation.

The financial burden of health care in the U.S. is staggering, with the country spending 18% of its gross domestic product (GDP), or approximately $5.1 trillion, on health care—nearly double the percentage spent by other developed nations. A recent report from the Commonwealth Fund highlights that the U.S. ranks poorly in health outcomes among eleven countries, with lower life expectancy and higher rates of chronic disease and maternal and infant mortality.

A significant portion of this expenditure, about 28% of the federal budget, is allocated to government programs including Medicare, Medicaid, and the ACA subsidies. These programs cover nearly half of the U.S. population, leaving around 170 million individuals either uninsured or reliant on private insurance.

To address the complexities and costs associated with the ACA, some experts propose a straightforward solution: eliminate the ACA and allow its beneficiaries the option to enroll in Medicare. The current monthly premium for Medicare stands at $203. This approach would not only simplify the system but also leverage Medicare’s lower administrative costs and built-in price controls, which have contributed to its relatively stable cost growth compared to private plans.

Dr. Ezekiel Emanuel has suggested various cost control measures in his column in the Washington Post on December 2, 2023. He argues for the establishment of a bipartisan commission tasked with proposing comprehensive reforms to the healthcare system. Such a commission could explore the integration of the ACA into Medicare, addressing the additional funding needed for this transition.

Moreover, the commission should prioritize initiatives promoting price transparency and drug price controls. These steps would empower consumers to make informed decisions, thereby reducing wasteful spending. While fraud constitutes only about 5% of costs in Medicare and Medicaid, enhancing accountability measures remains crucial.

As the United States continues to navigate this complex health care landscape, the call for action has never been more urgent. Dr. Bob Newman, a family physician with over 40 years of experience, emphasizes the need for decisive measures to reform the system and improve health outcomes for all citizens. He underscores that the time to act is now, urging Congress to tackle this pressing issue without delay.