1 00:00:02,400 --> 00:00:05,080 Speaker 1: Welcome to Wellna, Sun Mass. I'm doctor Nicoll Saffire and 2 00:00:05,120 --> 00:00:08,920 Speaker 1: this is your weekly rundown. Well, the Senate rejected both 3 00:00:08,960 --> 00:00:13,360 Speaker 1: the Democratic and Republican healthcare proposals, and frankly, this was 4 00:00:13,400 --> 00:00:16,480 Speaker 1: the right call. Now, if you haven't been watching the news, 5 00:00:16,640 --> 00:00:18,960 Speaker 1: there's a bit of urgency going on in Washington right 6 00:00:18,960 --> 00:00:24,360 Speaker 1: now because the expanded ACA subsidies that happened with COVID, 7 00:00:24,520 --> 00:00:27,280 Speaker 1: which is essentially a lot of federal dollars going to 8 00:00:27,360 --> 00:00:33,480 Speaker 1: insurance companies to help afford the Affordable aka Unaffordable Care Act. 9 00:00:33,960 --> 00:00:36,400 Speaker 1: They're set to expire in a couple of weeks at 10 00:00:36,400 --> 00:00:40,280 Speaker 1: the end of this month. Now, if those federal subsidies 11 00:00:40,360 --> 00:00:43,760 Speaker 1: are not expanded, millions of Americans are going to face 12 00:00:43,800 --> 00:00:48,440 Speaker 1: significant insurance premium hikes starting in early twenty twenty six 13 00:00:48,440 --> 00:00:52,680 Speaker 1: if they get their healthcare on the ACA marketplace. So 14 00:00:53,320 --> 00:00:57,400 Speaker 1: Democrats are saying, you absolutely have to expand those subsidies. 15 00:00:57,480 --> 00:01:01,000 Speaker 1: We do not want Americans having these high costs, and 16 00:01:01,120 --> 00:01:04,640 Speaker 1: Republicans are like, absolutely not. The Affordable Care Act has 17 00:01:04,720 --> 00:01:09,679 Speaker 1: failed and it is anything other than affordable. Well, so 18 00:01:09,959 --> 00:01:13,080 Speaker 1: in haste, you now have Democrats and Republicans trying to 19 00:01:13,120 --> 00:01:16,440 Speaker 1: put together bills by the end of the month to 20 00:01:16,520 --> 00:01:19,120 Speaker 1: try and fix this problem. And like I said, they 21 00:01:19,120 --> 00:01:22,360 Speaker 1: were both rejected, and that was the right call, because 22 00:01:22,760 --> 00:01:26,479 Speaker 1: whether it's Medicare for All on the left or some 23 00:01:26,560 --> 00:01:29,880 Speaker 1: half measures on the right, nothing is going to work 24 00:01:30,080 --> 00:01:33,040 Speaker 1: unless we address the real damage done by the Affordable 25 00:01:33,040 --> 00:01:36,400 Speaker 1: Care Act. So here's the reality. More than one third 26 00:01:36,400 --> 00:01:39,880 Speaker 1: of Americans skipped or delayed medical care last year because 27 00:01:39,880 --> 00:01:42,960 Speaker 1: of the costs. So that's not access to the care, 28 00:01:43,360 --> 00:01:47,200 Speaker 1: that's failure. The ACA shifted power away from patients and 29 00:01:47,280 --> 00:01:51,040 Speaker 1: doctors and handed it to the insurers and hospital systems, 30 00:01:51,360 --> 00:01:57,040 Speaker 1: fuel and consolidation, higher prices and ultimately lower quality. So 31 00:01:57,120 --> 00:02:00,320 Speaker 1: you don't fix healthcare by doubling down on what broke 32 00:02:00,360 --> 00:02:04,240 Speaker 1: it to begin with. A serious reform plan needs temporary 33 00:02:04,280 --> 00:02:07,480 Speaker 1: subsidy relief. Yeah, I know people don't want to hear it, 34 00:02:07,520 --> 00:02:09,520 Speaker 1: but you're going to have to give some money to 35 00:02:09,560 --> 00:02:13,240 Speaker 1: those subsidies because this is the bid they made. We 36 00:02:13,480 --> 00:02:16,480 Speaker 1: do not want Americans to suffer. So some sort of 37 00:02:16,560 --> 00:02:21,240 Speaker 1: temporary subsidy expansion, albeit maybe it should be reduced, and 38 00:02:21,320 --> 00:02:24,400 Speaker 1: there absolutely has to be a finite amount of time. 39 00:02:24,560 --> 00:02:27,560 Speaker 1: It shouldn't be two or three years, maybe six months, 40 00:02:27,600 --> 00:02:31,280 Speaker 1: maybe one year. Reality is for politicians, you want to 41 00:02:31,320 --> 00:02:34,160 Speaker 1: get people through the midterms, I get it. You also 42 00:02:34,240 --> 00:02:37,919 Speaker 1: need to enact aggressive fraud enforcement when it comes to 43 00:02:38,000 --> 00:02:44,799 Speaker 1: these subsidies and just ACA enrollment. Also take on expanded hsas, 44 00:02:44,960 --> 00:02:48,359 Speaker 1: those health savings accounts, the pre tax dollars. Not only 45 00:02:48,400 --> 00:02:51,640 Speaker 1: should you allow people to put money into it, but 46 00:02:51,800 --> 00:02:55,120 Speaker 1: also some of that subsidy money from the federal government. 47 00:02:55,240 --> 00:02:57,359 Speaker 1: It doesn't all need to go to the health insurance 48 00:02:57,680 --> 00:03:00,839 Speaker 1: Put some of that in hsas. For Americans, you want 49 00:03:00,840 --> 00:03:05,360 Speaker 1: to allow catastrophic coverage options because not everyone needs these 50 00:03:05,440 --> 00:03:08,799 Speaker 1: essential benefit plans from the Affordable Care Act. Let's think 51 00:03:08,840 --> 00:03:11,079 Speaker 1: of it when you think of oh gosh, let's think 52 00:03:11,120 --> 00:03:16,720 Speaker 1: of car insurance. Right, your car insurance doesn't cover you know, 53 00:03:16,960 --> 00:03:20,240 Speaker 1: filling up your tires and getting your oil change and 54 00:03:20,320 --> 00:03:23,200 Speaker 1: just doing all the basic care things that you do 55 00:03:23,280 --> 00:03:25,560 Speaker 1: to put along the life of your car. You have 56 00:03:25,680 --> 00:03:29,320 Speaker 1: car insurance for those catastrophic events like you get in 57 00:03:29,360 --> 00:03:31,680 Speaker 1: a big car accident or I don't know, if the 58 00:03:31,720 --> 00:03:35,200 Speaker 1: transmission falls out on the highway. That's what health insurance 59 00:03:35,320 --> 00:03:39,520 Speaker 1: is for. It's not to cover everything, like all wellness 60 00:03:39,600 --> 00:03:43,640 Speaker 1: visits and everything else that people are using their health 61 00:03:43,640 --> 00:03:47,720 Speaker 1: insurance for right now because of these mandatory essential benefits 62 00:03:47,760 --> 00:03:50,960 Speaker 1: put forth by the Affordable Care Act. That's a huge 63 00:03:51,000 --> 00:03:55,000 Speaker 1: reason why prices have gone off. Now. Another thing is 64 00:03:55,080 --> 00:03:59,160 Speaker 1: you have to bring back physician owned medical centers. They 65 00:03:59,280 --> 00:04:02,080 Speaker 1: outlawed it, said they couldn't do it. And so who's 66 00:04:02,120 --> 00:04:05,520 Speaker 1: now in charge of all the healthcare systems? MBA's venture 67 00:04:05,560 --> 00:04:09,320 Speaker 1: capitalists And what happened? What was a race to the bottom. 68 00:04:09,480 --> 00:04:12,360 Speaker 1: All of a sudden quality didn't matter, and you took 69 00:04:12,360 --> 00:04:15,560 Speaker 1: out a lot of that competition. And when that happens, 70 00:04:16,120 --> 00:04:19,640 Speaker 1: you're heading towards a socialized system. They essentially took away 71 00:04:19,640 --> 00:04:23,520 Speaker 1: the free market from our healthcare system. So what needs 72 00:04:23,520 --> 00:04:25,880 Speaker 1: to happen on the short term. You have to have 73 00:04:25,920 --> 00:04:29,440 Speaker 1: some sort of subsidy relief, and that means a short 74 00:04:29,560 --> 00:04:32,440 Speaker 1: term stop gap expansion of these subsidies. I think that 75 00:04:32,480 --> 00:04:34,760 Speaker 1: they should be reduced, and I think that there should 76 00:04:34,800 --> 00:04:37,840 Speaker 1: be a very small time that they are expanded for. 77 00:04:38,240 --> 00:04:41,000 Speaker 1: I think you need aggressive fraud enforcement with the ACA, 78 00:04:41,320 --> 00:04:44,039 Speaker 1: and you needed to expand the health savings accounts and 79 00:04:44,120 --> 00:04:48,400 Speaker 1: allow castrophic coverage options. More of the long term dismantling 80 00:04:48,440 --> 00:04:50,839 Speaker 1: the damage from the Affordable Care Act. You need to 81 00:04:50,839 --> 00:04:55,120 Speaker 1: bring back physician and medical centers, real price transparency, and 82 00:04:55,200 --> 00:04:58,800 Speaker 1: fewer prior authorizations standing between the patients and care. And 83 00:04:58,839 --> 00:05:00,839 Speaker 1: you really need to peel back the layers of those 84 00:05:00,920 --> 00:05:04,279 Speaker 1: essential benefits plans. Only then when you focus on that 85 00:05:04,320 --> 00:05:06,600 Speaker 1: short term and the long term, are we going to 86 00:05:06,680 --> 00:05:10,240 Speaker 1: begin to unravel the decade worth of damage the Affordable 87 00:05:10,240 --> 00:05:14,480 Speaker 1: Care Act has inflicted here in the United States. Put 88 00:05:14,480 --> 00:05:17,040 Speaker 1: patients and doctors back in charge, and health care is 89 00:05:17,080 --> 00:05:19,560 Speaker 1: going to start working again. Listen, this is not going 90 00:05:19,600 --> 00:05:22,000 Speaker 1: to be fixed in a week. It's going to take 91 00:05:22,040 --> 00:05:25,719 Speaker 1: a lot more time to peel back the layers of 92 00:05:25,839 --> 00:05:29,160 Speaker 1: damage the ACA has caused. But this is a start, 93 00:05:29,320 --> 00:05:31,560 Speaker 1: and I'm glad to see the conversation is back here. 94 00:05:31,640 --> 00:05:35,400 Speaker 1: We started at about eight years ago. Unfortunately COVID hit 95 00:05:35,600 --> 00:05:39,560 Speaker 1: it got delayed. But here we are again. But Republicans 96 00:05:39,560 --> 00:05:42,920 Speaker 1: and Democrats, you cannot rush this. This is very serious 97 00:05:42,960 --> 00:05:46,080 Speaker 1: and it affects everyone in the country. We need to 98 00:05:46,640 --> 00:05:49,599 Speaker 1: get back to a system where patients control the dollars, 99 00:05:50,000 --> 00:05:53,080 Speaker 1: quality will go up, costs will come down, and healthcare 100 00:05:53,160 --> 00:05:55,960 Speaker 1: can finally start working for the people it's meant to serve. 101 00:05:56,080 --> 00:05:59,000 Speaker 1: The Affordable Care Act was a poor attempt at socialized 102 00:05:59,000 --> 00:06:02,200 Speaker 1: medicine and it did just that. It drove down our 103 00:06:02,279 --> 00:06:04,680 Speaker 1: quality of care and it also drove up the cost 104 00:06:04,720 --> 00:06:07,159 Speaker 1: of health care. It was a disaster and it is 105 00:06:07,200 --> 00:06:10,159 Speaker 1: time to fix it, but we cannot rush it. This 106 00:06:10,240 --> 00:06:13,200 Speaker 1: is doctor Nicole Saffhire Wellness on MASS. Thanks so much 107 00:06:13,240 --> 00:06:15,560 Speaker 1: for listening. Make sure to tune in to Wellness on 108 00:06:15,680 --> 00:06:19,680 Speaker 1: Mass every Tuesdays and Fridays on iHeartRadio wherever you get 109 00:06:19,720 --> 00:06:21,680 Speaker 1: your podcasts, and I'll talk to you next time.