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Opinion

Op-Ed: The right way to repeal and replace Obamacare

Doctor and patient at Providence St. Joseph Medical Center in Burbank
A doctor examines a patient at Providence St. Joseph Medical Center in Burbank in 2012.
(Los Angeles Times)

More than six years after the passage of the Affordable Care Act, Republicans are still trying to craft a workable plan to repeal and replace it. The latest attempt was unveiled in May by Rep. Pete Sessions from Texas and Sen. Bill Cassidy from Louisiana. It would provide every American adult with $2,500 to buy health insurance while abandoning Obamacare’s top-down, regulation-driven approach. 

As a Republican who believes that Obamacare has not fixed longstanding national healthcare issues, and as a healthcare professional who believes that real reform is one of the most important issues in politics, I support the underlying principles of the Sessions-Cassidy plan. I want reforms that empower patients with greater choice, protect the doctor-patient relationship, decrease costs and increase quality.

But I also believe Republican attempts to fix healthcare, including the Sessions-Cassidy bill, aren’t going to work until the party fundamentally changes how it approaches this issue.

The GOP’s biggest hurdle is convincing the American people that it actually cares about patients. Right now, voters simply don’t trust the party on healthcare. An April poll by George Washington University found that 51% of likely voters trust Democrats to fix healthcare, compared with only 43% who trust Republicans. Tellingly, this 8-point gap exists even after Obamacare’s well-documented problems. 

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In order to overcome this gap, Republicans must bring in the people who are the most effective messengers on healthcare: Poll after poll shows that Americans trust doctors, nurses and others involved in medicine more than most any other group, yet Republicans have failed to take advantage of this. If the party hopes to make patient-centered healthcare reforms acceptable in the minds of Americans, it needs to make doctors and nurses, dentists and optometrists, specialists and family care physicians, and everyone else involved in healthcare an integral part of its strategy. 

My hope is that the Republican Party will learn from the Democrats and employ doctors in its effort to responsibly replace Obamacare.

Democrats understand this. In setting up Obamacare, ​President Obama and the then-Democratic majority in Congress routinely used healthcare professionals to lend their proposals credibility. The American Medical Assn. and the National Physicians Alliance threw their support behind the law. In the Democratic primary campaign, Bernie Sanders has done the same thing, engaging the labor union National Nurses United to promote his plan to institute a European-style single-payer system.

Despite the president’s​ deft use of physicians to boost his party’s proposals — and I would say to distract voters from its flaws and false promises — physicians are far from a monolithic group of Obamacare cheerleaders. A 2014 report by the nonprofit Physicians Foundation found that only 25% of doctors gave Obamacare an A or a B, while 46% gave it a D or an F. A 2015 poll by the Kaiser Family Foundation found that 36% of physicians believe the law has harmed their practice, compared with 23% who say it has improved it. The same poll showed that 44% of physicians believe Obamacare has made healthcare more unaffordable for patients — more than twice the number who say healthcare is now cheaper.

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My hope is that the Republican Party will learn from the Democrats and employ doctors in its effort to responsibly replace Obamacare. I have talked to hundreds of fellow doctors who are willing to do just that. A large number have wanted to play a more meaningful role in the healthcare reform movement, having seen how the Democratic Party mobilized many of our peers to move healthcare in the wrong direction. 

The GOP should create a program with the sole purpose of identifying, training and deploying healthcare professionals to be the primary messengers on healthcare — regular, private-practice physicians rather than big names or members of Congress with an MD. The party should give doctors a prominent role at the Republican National Convention. Finally, both the party and outside groups should support efforts to found and fund doctors’ organizations to counterbalance the ones that reliably endorse Democrats. 

The American people aren’t happy with Obamacare, and yet as time goes by, and its bureaucracy gets more entrenched, it will get only more difficult to undo it. Whether it’s the Sessions-Cassidy bill, House Speaker Paul Ryan’s upcoming plan or Donald Trump’s reform proposals, Republican efforts will continue to fall flat until they enlist an army of doctors and other healthcare professionals as allies and surrogates.

The party needs to invite in those who can speak to the issues with the most clarity, sincerity and authority. Until then, Americans will continue to think that Republicans don’t care about their healthcare, even though the party’s proposals are far more caring than the Obamacare status quo.

Dr. Joel L. Strom, a fellow at the Jesse M. Unruh Institute of Politics at USC, is a dentist in Beverly Hills.

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