Mr. Trump seems to think that fixing The Affordable Care Act is possible. As a retired registered nurse and very experienced consumer of health care by virtue of bad luck, I'd say he hasn't a bloody clue. The Affordable Care Act was broken when it was built. It continued to keep alive the notion that health is a commodity. This is delusional nonsense.
Health care, however, is a commodity when you refuse to give it to those who need it on an equitable and readily available basis. In other words, in America, you need to buy health care, no matter how desperately you need it. You must go through the humiliation when desperately ill of having someone question whether you are insured. Then, even if you are, you are forced to sign a contract saying you will be personally responsible for the bills if your insurance will not pay. Otherwise, they may well just not treat you, depending on how nasty the facility is, or they may just treat you badly. After all, how is a desperately ill person going to gather the strength to get a good litigation attorney or even submit a consumer complaint to a government body.
The other health care business model is like slumlords who collect huge government rental subsidies for housing the indigent. These health care providers treat anyone in an emergency room, as they must by law. Then the taxpayer ends up paying for those who cannot. These providers get an incentive for not promoting preventative health, follow up or health education. As long as they know the game, they collect. Big time. But the average taxpaying citizen hasn't a clue how this all happens and how expensive it is. It's like waging war ... there is no referendum about it ... the government decides for us.
But none of this makes health itself a commodity. You cannot actually provide health to anyone. A person must maintain his/her own health with whatever skills and tools are available. Some people will never have health, due to being brought into this world with genetic disorders which were entirely predictable by parents who were ignorant or willing to gamble with developing the life of another human being. Others will never have health because they contract diseases which cannot be cured. And others will never have health because of accidents or trauma sustained while engaging in violent activities, such as war. And others will never have health because they have neither money nor education.
A core question that faces Mr. Trump and Congress preceded the lousy Obamacare placebo: Are we a nation which truly cares enough to provide health care to everyone who needs it within our borders? People in our government have been trying to avoid answering that question for decades.
The behavioral answer so far on both sides of the aisle and in The Oval Office has been a definite and resounding "No!" Congress, Mr. Obama and now Mr. Trump, it seems, do believe in caring for all the health insurance companies and medical centers within our borders. And most of them seem quite healthy already, since they are usually associated with other investment entities. Their CEO's are paid vast sums. Insurance companies hire thousands upon thousands of nurses and doctors to review claims and fend them off whenever possible. (I know this because I briefly was one.) Medical centers get reimbursed by insurance companies and government. They even have the audacity to run donation campaigns.besides. They too hire thousands nationally to submit claims and argue with the insurance company reviewers. Its a real bureaucratic wet dream...which makes both sides rich at the expense of sick people and taxpayers.
There is only one way to fix The Affordable Care Act: Abolishing it entirely. If Americans were not kept so stupid generally about health maintenance due to bad educational systems, they would be marching on Washington for universal health care as a civil right of U.S. residents. This march would not require pink hats or superstar lunatics. It would require the American population's health education by those who are most knowledgeable about health. But, wait! How can that happen when those same people work for pharmaceutical companies, medical centers and insurance companies? Heartless capitalism wins again.