Memorandum

TO: Mr. Jose Luis Gomez

FROM: Rebeca Vergara
SUBJECT: The issue of Healthcare Reform in Modern American Politics
DATE: February 3rd, 2017

Description of Topic:
During the first weeks of Trumps presidency, radical changes surrounding
hot topics such as immigration and trade have swept the country. However,
one heated issue has come to an apparent halt in Congress: healthcare
reform. Following the implementation of the Affordable Care Act (ACA), the
law has been subject to scathing criticism, to the point that Congress
attempted to repeal the bill over 50 times under the Obama administration.
Now, even with the Republican-dominated Congress and Executive Branch,
the rush to repeal and replace is noticeably absent as lawmakers attempt
to create concrete, practical alternatives. A simple repeal of the ACA would
result in millions of Americans losing health coverage and billions dollars
worth of investment lost.
Amidst rising health insurance premiums and general healthcare inflation,
the American public and their lawmakers are divided on the solution across
partisan lines. The Republican Party hopes to reduce the federal role in
regulating health insurance and pursue different free market strategies while
the Democrat Party searches for ways to expand on current ACA provisions.
As is, the U.S. spends nearly twice as much on healthcare per capita relative
to other OECD countries, but still faces equal to worse health outcomes. As
U.S. healthcare expenditures approach almost 18% of the nations GDP with
no signs of slowing, the American public should be conscientious of these
issues and focus their energy on finding viable solutions tackling healthcare
inflation without stripping access away from the most vulnerable
populations.
Sources:
http://www.pgpf.org/finding-solutions/healthcare
Compares U.S. healthcare spending to other OECD countries.
https://www.cbo.gov/publication/52371
Quantifies U.S. healthcare spending in reference to national GDP.
Reason for Choosing Such Topic:
I chose this topic because of my professional interests in healthcare. In the
fall of 2017, I will be attending my first semester of medical school, and this
project serves as a good opportunity to do more extensive research into the
current state of the medical field. It is my strong belief that medical students
should not only aim to have strong foundation in the scientific basis for
disease, but also a comprehensive understanding of how medicine in is
practiced in the real world. Researching the challenges that the field faces at
both structural and political levels will bring me one step closer to that goal.

Causes and Effects of the Topic:

As mentioned above, the United States invests far more resources into its
healthcare system than what it yields. As a nation, we still have not achieved
universal access to healthcare even with unprecedented spending per capita.
The causes of healthcare inflation in the U.S. are diverse, but are strongly
linked to rising prices of drugs, medical devices, and hospital care.
The results of this defective system are visible in poor health outcomes,
including lower life expectancy and greater incidences of chronic conditions.
There is also ample evidence of major health inequities based a variety of
factors relating to race, gender, sexual orientation, education, income,
location, and much more. In low-resource settings, for example, health-care
costs for noncommunicable diseases can quickly drain household resources,
driving families into poverty. Thus, new policies proposed by Congress under
the new administration should ideally tackle the root causes of both health
inflation and health inequities in order for our healthcare system to be fair,
equitable and sustainable.
Sources:
http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-
health-care-from-a-global-perspective
Compares health outcomes in the United States from a global perspective.

Academic Sources:
http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandA
ndGreed.pdf
This article from the Time details the causes of costly medical bills and
proposes a greater a regulatory role of the government in order to reel in
healthcare inflation. The author, Steven Brill, gives the case for a more left-
leaning approach to healthcare reform.
http://www.heritage.org/health-care-reform/report/after-repeal-obamacare-
moving-patient-centered-market-based-health-care
This report from the Heritage Foundation, gives insight to a conservative
solution to healthcare reform that is more consumer-based in its approach.
The idea is that the consumers will benefit from competition within a free
market that would reduce healthcare costs.