By Dr. Christopher Peters

It is impossible for me to imagine that we will see any meaningful healthcare reform soon. Nothing substantive has been offered by President Joe Biden’s administration, despite earlier declarations that “Obamacare” would be expanded as “Bidencare”.  Given the logjam in the Senate, thanks in large part to Senators Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ), any proposal which is unlikely to be offered in the next few months seems equally unlikely to pass.

Furthermore, Republicans will likely retake the House following the midterm elections less than ten months away, and there’s at least an even chance that they will retake the Senate. If either or both happens, that would mean no chance for any substantive changes in healthcare policy for the remainder of Biden’s first term.

How about after the 2024 general election? That’s far too in the future for me to forecast, honestly. My assumption is that the Republican nominee will likely be either former President Donald Trump, or someone catering to his political base. Whether Biden wins or loses against any Republican challenger in 2024, I don’t see much hope of any serious healthcare reform.

Since the Affordable Care Act passed in 2010 under President Barack Obama’s administration, the GOP has not offered anything of value when it came to healthcare reform, in my opinion. “Repeal and Replace” didn’t go anywhere, and I don’t suspect that’s likely to change unless, and until, we see a significant realignment of our political compass.

I think that realignment is coming, sooner or later, and we need to prepare for whatever opportunities might arise for all Americans, from the political right to the political left, in the future.

I have written extensively about healthcare reform in this and other venues. It is perhaps the most complicated domestic policy issue we face, so I have decided to return to the subject and break it down in a new way. This is my introduction to a series which will explore the fundamentals of our healthcare system, step-by-step. This will get a bit “deep in the weeds” for some, but I’ll try to make these entries relatable and interesting.

Each installment will focus on one or two key points that are important to bear in mind when considering our overall healthcare system and the measures we might adopt to improve it. The reasons a fundamental understanding of our healthcare system is important are twofold. First, I believe our current system is so expensive and unequal as to be indefensible; we need a change. Second, all the proposals advanced to date would not adequately address the underlying problems I see in our healthcare infrastructure. We’ll turn to some of those in later installments.

So, where to turn? I suggest we begin by looking at which healthcare systems have been implemented in other countries. For homework, which is more enlightening and less tedious than you might remember from your school years, I’ll ask you to check out a PBS Frontline documentary featuring correspondent, T.R. Reid, titled Sick Around the World. It’s a bit dated, having come out in 2008, at the outset of the healthcare debate leading to the ACA.  But, honestly, not much has really changed. Reid also has a book, published in 2010, called The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, which echoes the same points as the documentary.

I’ll be back next time to explore the four primary models of healthcare around the globe.

Dr. Chris Peters is a Contributing Scholar to ITR Foundation, a 9-year Army Medical Corps veteran, a surgeon, and a small-business owner in Coralville. He was also the Republican candidate for U.S. Congress in Iowa’s 2nd District in 2016 and 2018. Most importantly, Chris has been happily married to Julie for 26 years, is the proud father of three adult sons, Cole, Jake, and Caleb, and is the delighted grandfather to Jake’s son, Liam.