policy

Pros and Cons of the American Health Care Act

The Republican establishment has longed to repeal Obamacare basically since it became law in 2009. Conservative politicians have centered their campaigns around repealing the health care law, while President Donald Trump promised to get rid of “horrible” Obamacare during rallies.   Image: Source   On March 6, House Republicans revealed Obamacare’s potential replacement: The American Health Care Act (AHCA). The bill has quickly passed through three different house committees before many have had time to fully comprehend its implications. So, who benefits from this new bill and who doesn’t? Let’s list some pros and cons.   PROS – Repeals individual mandate Perhaps the most central (and most criticized) proposal of Obamacare is the individual mandate. This mandate requires all individuals to purchase health insurance. Although both Democrats and Republicans lauded the idea of an individual mandate when it was a part of Mitt Romney’s health care plan in Massachusetts, it quickly came under fire when proposed in Obamacare. Opponents described it as an unconstitutional attack on individual freedom—to them, no one should be forced to buy insurance. This criticism does make sense. For example, if you’re a healthy young person, you might not want to spend a lot of money on health insurance that you probably don’t really need. With that said, for these individuals who are passionate about their individual liberties, the AHCA’s repeal of the mandate is...

How Much Medical Education is Actually Necessary?

A common theme to many of my posts here on The Almost Doctor’s Channel is the idea that we are at a point of great change in the medical field. I’ve covered such topics as how our healthcare system falls behind that of other countries, how the match can be improved, and how we can improve science literacy. Another area of my interest (and one that is readily apparent to those of us who are currently in medical school) is the design of medical training – notably its excessive length.     Currently, after four years of undergraduate education, one must complete four years as a medical student followed by three to six years as a resident before being able to independently practice medicine. If no gap years are taken, this puts a person at 29 to 32 years of age when they are first able to contribute to the physician workforce – or even older if their specialty requires further fellowship training. If they decide to go into medicine later or circumstances prolong their education, this pushes them back even more. Because of this, some are hoping to shorten medical education.   As we look to shaping the future of medical education, though, it is important to note that this excessive length is a modern phenomenon, one that arises out of a desire to bring regulation and excellence...

ACA Repeal – Good or Bad for Doctors?

As Trump is sworn in as the 45th President of the United States, the Republican-led Congress is making strategic moves to repeal the Affordable Care Act (ACA), a.k.a. “Obamacare.” Despite their promises to immediately replace the ACA with a new plan, no solid details have been given out by Trump or Republicans.   The effects of the ACA on the lives and practice of doctors has been complex, and opinions as to whether the law has been good or bad for doctors are clearly divided along party lines. There is high anxiety surrounding the proposed repeal from patients and doctors alike. Without a clear plan in place, it’s hard to know how a repeal would affect doctors and the future careers of current med school students.   Image: Source   Here are some concerns when considering the repeal:   Fewer patients in a smaller insurance pool – The ACA has enabled roughly 22 million previously-uninsured Americans to purchase health insurance or obtain it through expanded Medicaid programs. The ACA also has rules in place that end pre-existing condition exclusions for children, allow young adults under the age of 26 to be covered under their parents’ insurance and prohibit arbitrary withdrawals of insurance coverage. If repealed with no immediate replacement, millions of people could be dropped from their plans and left unable to purchase new plans. Fewer people with insurance equals...

What Can Angelina Jolie Teach Us About Gene Patents?

Angelina Jolie’s op-ed in The New York Times about her preventive double mastectomy sent shockwaves through the media. She represents a new generation of patients who are able to use genetic testing to make empowered, evidence-based decisions. While experts agree that her description of the procedure resulting in a breast cancer risk reduction from an 87% to a 5% chance might be an oversimplification, her courage in the face of such a difficult choice is laudable. Jolie now joins a class of “previvors,” unencumbered by the social stigma of these types of preventive procedures.   None of this could be possible without the BRCA1 and BRCA2 test, which helped to identify the mutated genes linked to cancer. But as Jolie so adeptly points out in her piece, “The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.”   The simple truth to take away is that while Jolie’s example will inspire many individuals to jump over the social stigma of preventative procedures, there is still one large hurdle to cross: gene patents.    Last November, the Supreme Court heard the case Association of Molecular Pathology v. U.S. Patent and Trademark Office, concerning gene patents for BRCA1 and BRCA2 held by Myriad Genetics. An article in The New York Times explains the company holds patents for “two human genes, which, when mutated, give a woman a high risk of getting breast or ovarian cancer. The patents give Myriad...

History Of Healthcare In America #10: The Last Century

Since this is the last article in the series, here’s a quite interesting video depicting the history of American healthcare in the forms of political cartoons. As shown, the growing importance of this topic in the first few decades of the 20th century gave rise to a host of complexities, interactions, inconsistencies, and issues. Given our history, what can we look forward to for the future? Will we be able to strike the right balance between affordable costs and effective care?     Healthcare is one of the hottest topics in discussion today. But how exactly did the American healthcare system come to be? What were some of the dynamic modifications and transformations it went through in order to embody its present form?   Rather than looking at it from a purely chronological and historical perspective, let’s analyze the progression of healthcare from a political viewpoint. The politics and policymaking around this topic has been marked by constant debate and controversy. Our presidents have been some of the most vocal advocates on this matter, shaping the course of healthcare over the past several decades.   Thus, in the course of the next several articles, we will be looking at short clips from presidents, both recent and past (yet undoubtedly notable). My hope is to gain a better understanding of the past, present, and hopefully the future of healthcare. Who...

History Of Healthcare In America #9: Truman

As it turns out, the idea of universal healthcare goes back all the way to the presidency of Truman. As shown in this video here (with useful content primarily after timestamp 3:20), Truman emphasized the necessity of assuring access to healthcare for all Americans. The dynamic changes that medicine has undergone over the years along with evidence of sustainable nationalized healthcare systems around the world attest to the validity of this idea, leading up to the current enactment of the Affordable Care Act.     Healthcare is one of the hottest topics in discussion today. But how exactly did the American healthcare system come to be? What were some of the dynamic modifications and transformations it went through in order to embody its present form?   Rather than looking at it from a purely chronological and historical perspective, let’s analyze the progression of healthcare from a political viewpoint. The politics and policymaking around this topic has been marked by constant debate and controversy. Our presidents have been some of the most vocal advocates on this matter, shaping the course of healthcare over the past several decades.   Thus, in the course of the next several articles, we will be looking at short clips from presidents, both recent and past (yet undoubtedly notable). My hope is to gain a better understanding of the past, present, and hopefully the future of...

History Of Healthcare In America #8: Eisenhower

In contrast to the prevailing opinion of the Republican Party as it stands today (and might likely have been along the same lines at the time), Eisenhower presents a plan here in this video that embraces greater involvement of the federal government in the health and welfare of individuals. While the avoidance of socialism remained to be a crucial issue at this time, Eisenhower nevertheless emphasized the need for better healthcare for all Americans, with concrete steps towards improvement.     Healthcare is one of the hottest topics in discussion today. But how exactly did the American healthcare system come to be? What were some of the dynamic modifications and transformations it went through in order to embody its present form?   Rather than looking at it from a purely chronological and historical perspective, let’s analyze the progression of healthcare from a political viewpoint. The politics and policymaking around this topic has been marked by constant debate and controversy. Our presidents have been some of the most vocal advocates on this matter, shaping the course of healthcare over the past several decades.   Thus, in the course of the next several articles, we will be looking at short clips from presidents, both recent and past (yet undoubtedly notable). My hope is to gain a better understanding of the past, present, and hopefully the future of healthcare. Who knows, we...