Top Republicans vow to fix what ails healthcare as part of their presidential platforms
Some of my earliest memories of politics revolve around the New Hampshire primary contests leading up to the 2008 U.S. presidential election. I was a high school student at Hanover High School in Hanover, New Hampshire, eager to make my voice heard and cast my first ballot as a newly minted 18-year-old in November 2008. I knew I should be prepared and well-informed. It was my duty, and part of the New Hampshire cultural fabric (as it remains today).
So, I made it a point to listen to all candidates’ platforms – both those I agreed with, as well as those I did not agree with – during the primary race, even though I knew I couldn’t vote until November given my age.
I attended town halls, listened to advertisements and witnessed speeches that had audiences ranging from dozens to hundreds (or maybe even thousands) of people. Interestingly, I recall healthcare being a top priority for many campaigns, a policy area that had impacted (mostly negatively) Americans from all backgrounds. That always stuck with me.
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Everyone promised to fix the issue. Affordable, high quality healthcare for all Americans was the universal goal, with each candidate varying in the specifics on how to achieve it.
Presidental candidates aren't just focused on the economy. Healthcare has become a major issue. (iStock)
Fast-forward over 15 years, and healthcare is still not "fixed" despite continued promises and even highly touted laws being passed, such as the passage of the Affordable Care Act (ACA), or Obamacare, over a decade ago. While some may argue we’ve made some progress, it’s not been nearly sufficient.
Costs continue to skyrocket, clinical outcomes are often inconsistent, prescription drug prices remain astronomically high for many and access remains uneven across countless demographics.
Pair those factors with historical inflation and a mass exodus of healthcare professionals who are burnt out in the setting of increasing bureaucratic barriers to care and decreasing reimbursement, and it’s no surprise that healthcare remains a major concern of voters in New Hampshire and nationwide. In fact, eight in 10 voters say the affordability of healthcare is "very important" for candidates to discuss on the campaign trail.
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Leading Republican candidates are starting to appreciate the importance of healthcare to voters, as well as President Joe Biden.
At the end of November, former president Donald Trump announced he was "seriously looking at alternatives" to the ACA if elected to a second term, though specifics have yet to be announced. The former president does have some healthcare wins to his credit while in The White House.
Those include leading bipartisan initiatives on healthcare price transparency, which is supported by nine in 10 Americans and has been continued under the Biden administration, and initiatives like "Patients Over Paperwork," launched by former Centers for Medicare and Medicaid Services administrator Seema Verma. He also moved "right to try" policy forward to allow Americans who are sadly terminally ill seek access to investigational medications.
But it is not just Trump who has begun to take on healthcare as the race for the Republican nomination for the 2024 U.S. presidential election heats up. Former UN ambassador and South Carolina governor Nikki Haley, who also appears lukewarm on the ACA, has highlighted the importance of medical malpractice reform to allow doctors and patients to work collaboratively to improve health, not just focus on "defensive medicine" that drives up costs by encouraging unnecessary care to avoid lawsuits.
Fast-forward over 15 years, and healthcare is still not "fixed" despite continued promises and even highly touted laws being passed, such as the passage of the Affordable Care Act (ACA), or Obamacare, over a decade ago. While some may argue we’ve made some progress, it’s not been nearly sufficient.
Additionally, her support of health savings accounts and willingness to acknowledge that the next president must tackle the reality that many entitlement programs, including Medicare, are running out of money and need an overhaul demonstrate her understanding that healthcare issues negatively impacting Americans must be addressed.
And the other remaining Republican candidates? Florida Governor Ron DeSantis recently reported his health plan would "supersede" the ACA, though provided no clear details. Entrepreneur Vivek Ramaswamy has promoted increasing health insurance options and competition that cover "actual health."
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David N. Bernstein, MD, PhD, MBA, MEI is a resident physician at the Harvard Combined Orthopaedic Residency Program at Massachusetts General Hospital, Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, and Boston Children’s Hospital and a Senior Researcher in health care transformation at Harvard Business School. Follow him on X (formerly Twitter): @DNBernsteinMD.
