Health Care (If You Care) Beyond Politics--The Obama and Trump Doctrine

ALPERN AT LARGE--There have been and will be those who cannot divorce politics from health care--and they're probably part of the problem.

There have been and will be those who refuse to understand that health care, like life, is VERY complex and will insist on childlike answers that have no merit or clinical utility--and they're definitely part of the problem.

After President Obama, the ability to say "do nothing" about health care coverage was OVER. Many folks, particularly Republican politicians, blew that one off for years and helped get President Obama elected. 

When they thought they could bring back the realm of discriminating against those with pre-existing conditions, they got thrown out of the House (waaaaaay more than any anti-Trump sentiments in the critical suburban swing districts). So goodbye, Paul Ryan, and hello again to not being forced to be poor just because you got cancer. 

The Obama Doctrine of Health Care both helped and hurt him with Americans--he pretty much said "Never Again to Doing Nothing" but he got played by the health plans/insurance plans that got us into this mess and who wrote the ACA.  

President Trump got played by Paul Ryan and a ridiculous/ideological purist House and Senate that refused to come up with tough compromises that people could use. Both the mega-socialist and mega-capitalist approaches to health care are full of economic and health-based misery, and really don't work well in the adult world ... 

... and they don't work well with doctors, either. 

Enter the Trump Doctrine--"Never Again to Excessive Generic Prices, and Never Again to Prices that are dramatically different between Europe/Canada and the U.S." 

The BIG problem with health care drug costs (and it's only ONE part of the cost conundrum with health care) is NOT the blockbuster new drugs that are very expensive to make (monoclonal antibodies and biologic medications) but rather GENERIC MEDICATIONS ARE TOO DAMNED COSTLY. 

Legal and prosecutorial efforts are under way against generic drug companies, who are doing anything BUT being capitalistic and encouraging competition. 

It's a monopoly/oligopoly of life-threatening proportions, and it's making dollars get sold in the hundreds or thousands of dollars yet are made for pennies in today's technologically-advanced society, and for medications older than most of you reading this have been alive. 

Generic competition has been encouraged like never before by the Trump Administration so that the option of more and greater competition to reduce drug costs is greater than ever.

Both the carrot and the stick have been offered to generic drug companies that know damn well they're overpricing life-saving drugs, and now that Paul Ryan is gone, and Nancy Pelosi runs the House, it's likely that generic drugs will finally be pressured and/or offered opportunities to lower their prices. 

Do the socialists who will "make" the companies lower their costs have a better answer than the capitalists who let the costs go up? Probably not--but hopefully, now that this election cycle is over, we can get to the heart of this problem in a bipartisan way. 

It really doesn't matter if the Obama or Trump Doctrines of Health Care are appreciated for what good they bring, or not, because the problem isn't going away: Life is a nightmare without health care and coverage, and the affordability of that health care and coverage is destroying us all.


(Kenneth S. Alpern, M.D. is a dermatologist who has served in clinics in Los Angeles, Orange, and Riverside Counties, and is a proud husband and father to two cherished children and a wonderful wife. He is also a Westside Village Zone Director and Board member of the Mar Vista Community Council (MVCC), previously co-chaired its Outreach Committee, and currently is Co-Chair of both its MVCC Transportation/Infrastructure and Planning Committees. He was co-chair of the CD11 Transportation Advisory Committee and chaired the nonprofit Transit Coalition and can be reached at alpern@marvista.org. He also co-chairs the grassroots Friends of the Green Line at www.fogl.us. The views expressed in this article are solely those of Dr. Alpern.)