As President-elect Donald Trump and the Republican-controlled Congress debate how to repeal and replace the Affordable Care Act (ACA), Mayo Clinic President and CEO John Noseworthy, MD, feels a key concern has been forgotten: the health of patients.
In a Washington Post interview, he said while the ACA has expanded access to health insurance for millions of Americans, it has also created barriers to care.
“Patients are getting frustrated and fearful and anxious that they can't have access to the care that's best suited for them,” Noseworthy said. “How can you have a great country if our citizens can't get access to world-class healthcare? It's actually not a bad time to reassess.”
The ACA debate has been too focused on premiums and problems with Healthcare.gov than on “what patients need,” according to Noseworthy, all while narrow network plan designs have become more common and physicians are spending more time on paperwork than meeting with patients.
A new administration means an opportunity to address those issues, and Noseworthy feels healthcare professionals aren’t “freaking out” about how Trump’s policies could affect them. He did, however, recommend a cautious, “surgical” approach to replacing the ACA.
“We’re really talking about replace and repair, rather than repeal. But we haven’t seen a full approach yet from the administration. Personally, this is me speaking, I don’t think it’s a bad thing—I’d rather be called in to a careful review and assessment of the situation and a thoughtful approach to a very complex problem, rather than a quick fix, which could be fundamentally flawed,” Noseworthy said. “We’re basically optimistic we can create a better system together.”
When asked what should be kept from the law, Noseworthy pointed to the same two components Trump himself likes: covering people with pre-existing conditions and keeping children under 26 on their parents’ plans. Insurers have warned those provisions alone could create a “death spiral” in the market if the requirement to have insurance is removed.
A positive of the ACA, according to Noseworthy, was how different parts of the healthcare industry changed practices, and he believes that cooperation can be utilized to craft a better version of the law.
“I think the multiple sectors are working together and recognizing they all have to work together to create a better outcome, whether it's a device company or a payer or an employer or providers,” he said. “I think we weren't in that situation five to eight years ago, where we all saw we're part of the solution. I think it's a good thing.”
Read the full interview here.