An interesting area of our economy to watch will involve health care, although there will be numerous areas of the economy that could be shocked, primarily in a negative manner for the average consumer, during the next two and possibly four years. In most areas of the overall economy, benefit will be realized by the most affluent of society often at the expense of most Americans. Because health care touches everyone in some way, either directly or indirectly, is of great importance to the overall wellbeing of the country.

It is the general philosophical position for decades by the Republican party that health care is the responsibility of the individual either by purchasing health care insurance within the open market or relying on employer-based health care insurance coverage. Even though President Nixon contemplated national health care when he was president in the early 1970’s and Senator Edward Kennedy rejected his plan, something Sen. Kennedy regretted to the end of his life, the Republican party has generally been against a federally mandated universal health care plan. That is the principal reason why the U.S. is the only developed nation in the world that does not have some type of universal or national health care plan.

The top 5 countries with the highest healthcare expenditure (% of Gross Domestic Product- GDP) are Afghanistan: 21.83% Tuvalu: 19.97% Liberia: 16.62% United States: 16.57% Palau: 16.38%. This is not the group of countries that the richest nation on the planet should be compared with on the issue of health care expenditures. This level of spending has not produced better outcomes, in fact the outcomes are average at best in most measured areas of health care outcomes.

There have been numerous reports which have concluded that some form of universal or national health care plan would produce savings for the health care consumer and not negatively impact our health care outcomes. If a Republican president in the early 1970s thought a universal or national health care plan was a good idea, why hasn’t it been implemented?

The U.S. has a health care system driven by care and profit. When profit is a highly motivating factor there is a concerted effort to maintain that profitability. Feeding political campaigns huge sums of money is being done to ensure the status quo of a profit-driven health care system is maintained. The Republican party and a few corporate Democrats do the bidding of the small number of ever consolidating health care corporations, including Big Pharma. This legalized bribery, thank you Supreme Court, maintains a system that demands and thrives on profitability. A system largely designed to provide care after you get ill, not prevention designed to reduce illness. Often doctors are taken out of the equation when insurance companies dictate what is allowed to minimize their liability for payment. Our system permits a great number of personal medical bankruptcies, over 600,000 per year, that no other developed country experiences even close to this scale. This is a system that has become so dysfunctional to the point that it requires serious reform or complete overhaul.

During the next few months and years, you will see serious attacks on our health care delivery system, particularly Medicaid and to a lesser degree Medicare. Always keep in mind that most of these cost cutting efforts are designed to provide cost savings on the backs of a majority of the population to help pay for a massive tax cuts for the most affluent in our society. President Trump in his first term expanded our accumulated debt by $8 trillion (40+%) and he personally has no problem doing so in his second term. Many of his fellow Republicans are fiscally conservative, so balancing the need to pay back the big money donor class with tax cuts and cutting trillions in federal spending that will hit hard on many of their voters could prove very difficult. It is very likely the tax cut will pass in the upcoming Congress and some spending cuts will take place, but not nearly enough to offset the tax cut. Again, future generations will be asked to pay for the folly of a government that has become so irresponsible and dysfunctional that it puts most Americans at great risk.

The Republican party despises the Affordable Care Act (Obamacare) and might repeal this limited effort at expanding health care insurance to millions of previously underinsured or uninsured individuals and households. Unless there is a suitable replacement for Obamacare, tens of millions will find themselves without health care insurance coverage. As stated before, what the next two or four years bring could range from troubling to downright horrific …we will just have to strap in for the ride.