Meidas Health: Former VA Secretary Dr. David Shulkin on America’s Health Care Crisis
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How does Dr. David Shulkin introduce the current U.S. health care crisis?
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Midas Mighty, welcome to another episode of Midas Health. There's a lot that's happening that, frankly, I think is confusing when we think about the changes or proposed changes to federal health policy from the Trump administration. And there are very few people in the country like Secretary Dr. David Shulkin to help us figure it all out, to help us navigate through this very complex policy situation. Dr. Shulkin has served both President Obama and President Trump. He was most recently the secretary of the VA for the Trump administration, served in very high senior ranking roles under the Obama administration, has been confirmed by the Senate some of those roles to a vote of 100 to zero. I just found that out because I was warming up an audience for him in Philadelphia at a healthcare conference a few weeks ago, and we had the chance to reconnect.
I said I'd love to have him over at Midas Health, and he graciously accepted. So I'm excited to have him join and for all of you to listen to his perspectives, especially at this really important time for the country. Secretary Shulkin, thank you for joining Midas Health.
I'm glad to be with you today, man.
I know there's a lot that we can cover, but I wanted to make sure our listenership had a chance to get your perspectives on everything that's happening when it comes to affordable care act marketplaces potentially not being as hospitable to coverage as in years past. new proposals from the president suggesting that HSA health savings accounts might actually be the focus of the current administration. There's a lot there for those of the many out there who aren't spending their entire days thinking about these terms and these programs. I'm wondering your thoughts on what you're seeing and if you can help us wade through this confusion.
I think that all of us that spend our time in health care understand how complicated this is. And if you now bring this up to a political level where people that don't spend their time in health care but are responsible for making policy for the country, take a look at it.
Why does Shulkin say ACA subsidies are only a band‑aid for an unaffordable system?
They're frustrated, too. And I think what we're seeing here is very interesting. The recent shutdown, the continued debates have really focused on ACA subsidies, but What ACA subsidies really are are a band-aid to a broken system that's really become unaffordable and non-sustainable. And unfortunately, what we're seeing is that neither the Republicans nor the Democrats have a plan for comprehensive reform to fix this system. And in fact, the last time that we had a holistic view of the system was back in 2009 with the advent of Obamacare, which means that we're really looking at thinking that developed in 2006 to 2008, if policy happened in 2009. And so what we're seeing is 15 years of really not addressing the systemic problems in the health care system.
And I think that's where this frustration is boiling over. And that's what we're seeing right now.
Are you of the mind, you said this when I heard you in Philly at that fireside chat at Penn, and I loved it because I agreed with it, but it feels like Democrats and Republicans, to paraphrase you, neither party seems to have a plan in place for a long-term fix for our healthcare system. But I'm wondering if you can elaborate.
Yeah. Well, first of all, I think we are going to get there on some type of agreement on the subsidies because in the absence of a plan, the subsidies are the only thing that are going to provide some type of transition to hopefully a better system. And so what really needs to happen is we need to be able to have the political will to recognize that the current system of paying
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Chapters
8 chapters
1
How does Dr. David Shulkin introduce the current U.S. health care crisis?
0:01–2:34
2
Why does Shulkin say ACA subsidies are only a band‑aid for an unaffordable system?
2:34–5:35
3
What evidence does Shulkin give that neither party has a long‑term health reform plan?
5:35–8:34
4
How would changing reimbursement and reducing fragmentation improve care and costs?
8:34–11:00
5
Will extending enhanced premium tax credits avert a near‑term insurance coverage collapse?
11:00–14:40
6
Can Health Savings Accounts replace ACA subsidies and increase consumer control?
14:40–17:25
7
How realistic is price and quality transparency for changing patient behavior?
17:25–19:35
8
What are the implications of proposed federal limits on graduate loans for the health workforce?
19:35–20:14