This is a guest article by Silvio Aladjem MD.

You have heard it again and again during the 2015 electoral campaign. It was supposed to be one of the first actions of a Trump administration, if elected. Repeal and Replace the Obama care. As you know, it did not happen.


Well, it depends on who you ask: The White House or the Congress, the Hospitals or the Doctors, the person on the street, the pundits, or the Insurance Companies. No two answers will be the same. Total confusion: repeal and replace, modify, leave as is, you name it and it was talked about at some time.

A closer look at the “why”, will reveal that behind every proposal there are some deep-rooted interests fighting for adoption of their position. In the mix, the looser is the American people the interests of which are not a priority for anybody. That is disheartening.

In most countries where a health care system is available for all, it is always run by the government as a single payer. Like Medicare or Medicaid in the United States. It may not be perfect. But it works. The idea that we will have a health care system that is still in the hands of the Insurance Companies is, in my opinion, absurd. Insurance companies are businesses that must make a profit. Their profit will come by paying out less than they take in. The less they pay out the more money will they make. Their bottom line is not how healthy the American people are but how much profit will they generate. Don’t take me wrong. One is in business to make money. That will never change nor should it.

One presumes, however, that the Government, de facto the single payer for a universal national health care system, has an interest in the health of its people and not in the bottom line of the program. Look at the UK, the Scandinavian countries, Canada or wherever a universal health care system is available to all.

What we are trying to adopt, instead, is a system whereby free enterprise, i.e. Insurance Companies, coexists with a Government designed program with its regulations, which assures, among other things, that the private sectors make a profit. If this design would make the subject of a reality show or TV comedy, it would be hilarious. As is, it is instead pathetic.

Reinventing the wheel is not a clever idea no matter where it is applied. It shows lack of imagination, sometime dishonesty or, like in this case, ignorance mixed with political interests.

The idea of a universal healthcare system was, originally, political. From the beginning, the Affordable Care Act (ACA), also known as Obama Care, was neither universal nor affordable. The subsidies, the mandate, the interaction with Insurance Companies, the variations in implementation from State to State, and other aspects of its rules and regulations, doomed the program from the beginning.

I believe it is the only piece of legislation where the Speaker of the House at that time, Nancy Pelosi (D), asked the Members of the House to vote so that they can find out what’s in it.

Now, 9 months in the Trump administration, politicians can’t even decide to bring a new proposal to the floor or vote.

What would have been wrong to enlarge Medicare or Medicaid, which work even if not perfect, with the Government as single payer? Well, of course, that would not be ok with the Insurance industry. A single payer means billions and billions in lost profit.

So, we better reinvent the wheel. It will still be round, while we will go around and round and round trying to understand it and figure out how to pay for it.

Sheer insanity.
SILVIO ALADJEM MD, an obstetrician/gynecologist and Maternal Fetal Medicine (high risk obstetrics) specialist, is Professor Emeritus in obstetrics and gynecology at Michigan State University, College of Human Medicine, in Lansing, MI. He is the author of “10,000 babies: my life in the delivery room” now available on Amazon, Barnes and Noble and other book stores. Dr. Aladjem published extensively in Scientific Medical Journals and wrote several textbooks in the specialty. Should you wish to contact him, you may do so at: dr.aladjem@gmail

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