My father, who died of cancer at the age of 57, was a builder. Anyone who knows how to build a home knows a foundation is needed. The current national discourse about how to improve our health care system reminds me of my father’s work. The two main solutions to improving health care for all Americans fall on different ends of the political spectrum, both of which are unsustainable because they don’t have foundations.
Montanans expect and deserve access to affordable, high quality health care, but leaders who argue we can get there by either repealing the Affordable Care Act or passing Medicare for All would establish a new system without a foundation.
While initially controversial, the Affordable Care Act has provided significant coverage to Montanans who otherwise wouldn’t have any coverage at all. Indeed, Montanans no longer have to worry about being denied coverage due to having a preexisting condition. Our uninsured rate is at its lowest in years. And bad debt for hospitals across this state significantly decreased.
This is not to say that the ACA has been a perfect solution: We face enduring problems in access and affordability. But at this point in our history, let’s build on the foundation that has already been established. Creating a new system or repealing the ACA will undoubtedly put our rural hospitals in financial jeopardy.
While a “one-size-fits-all” proposal might seem enticing, the reality is that it won’t work for everyone. In terms of health care delivery, Montana faces challenges other states with big cities do not, simply because half of our population is rural. We want our patients to be served in the communities in which they live and eliminating private coverage for Montanans in favor of a system that doesn’t cover a hospital’s costs will result in Montanans traveling even more to get the care they need. We should not be eliminating access to care when we’ve made so much progress in improving it.
To be sure, as someone who works for a health system, hospitals recognize our role in improving the delivery of care to our fellow Montanans. We can do better, too, and ultimately, my experiences working for my father have convinced me that the best way to improve our health care system is to build on the foundation that’s already in place.
Jesse Laslovich, of Helena, is regional vice president for network development for SCL Health Montana. He previously served 10 years in the Montana Legislature and as chief legal counsel for the Montana securities and insurance department.
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