” CNN Debate – Future of Obamacare – No Clear Model but Whims of Candidates Rule and Persist ” – February 7, 2017.

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Of President Donald Trump’s two key platforms on which rested his election success : (a) Gain in quality, safety, and security of Americans; and (b) Repeal & replacement of Obamacare, new trade deals, and tax reforms; – the second (b) was put to test in the debate arguments in Washington University, between Senator Bernie Sanders (I), and Senator Ted Cruz (R) this night.

Senator Bernie Sanders and Senator Ted Cruz, the debaters.

Senator Bernie Sanders and Senator Ted Cruz, the debaters.

Jake Tapper and Dana Bash,  CN . Moderators.

Jake Tapper and Dana Bash, CN . Moderators.

Jake Tapper and Dana Bash of CNN moderated the debate.

Rather than going into the details of questions and answers in this debate, I would like to present just the salient arguments of both the debaters on three characteristics constituting the fearures, the three legs of a stool i.e. ‘Obamacare’.

The picture below presents the characteristics in terms of a triangle that I am usually fascinated with in representing my simple, commonsense take.

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Quality, Efficiency, and Funding are the key characteristics on which the success or otherwise of any Health Care Plan will stand upon.

1. Quality : This refers to accomplishing the task with high grade excellence. Senator Bernie Sanders admitted that Obamacare is not perfect, but needs quality improvement. Insisting upon the fact that America is the only country in the world not to guarantee Healthcare as a right and not a privilege, he pushed for better government control/mandate rather than leaving it in the hands of states for enhancing quality. Affordability and not mere access (as the republicans would favor) is the answer.

Senator Ted Cruz while agreeing that Healthcare is the ‘future of America’ favored a system enabling people/patients to set their health priorities themselves without the government trying to establish the priorities and setting every stage of action. He precisely positioned the election victory of Republican,Donald Trump, as a referendum on Healthcare issue. With premiums shooting up, deductibles rising, doctors’ choice not being favorable, the quality of Obamacare has become a suspect. Government control is not working is his thrust of the argument.

2. Efficiency : This refers to doing what is intended with the requisite power and resources to bring about results. Strongly advocating availability of a Medicare type of public option in all states as a solution to boost its efficiency, Senator Bernie Sanders compared the system with other counntries like Canada, England, and Sweden where the Healthcare is better, but an American paying twice per capita for the benefits of Healthcare is not the right end. He lamented that the system has become wasteful, dysfunctional, and bureaucratic impacting Healthcare implementation.

Senator Ted Cruz also resorted to comparison with other countries in terms of waiting times for some services, hip replacement, appointment with specialists providing statistics in the process to urge the need for improving efficiency of treatment. Senator Cruz also added that most people covered in Obamacare are from Medicaid, reflecting the importance of private insurance where competition can get rates lower.

3. Funding : This refers to source and supply of money and other resources for support. Breaking the strong influence of insurance companies, medical equipment suppliers, and the big pharmaceuticals can boost the funding for the Healthcare program is Senator Sanders’ main thrust here. Tax reforms is another, he stressed.

Senator Ted Cruz cited the profit of 10 large companies in 2008 at $ 8 billion having risen to $ 16 billion in 2016 as proof of government control not working well and focused his view to private insurance even while drawing attention to the proposal that the Republicans have put forward in this matter.

Conclusion : Bernie Sanders has been reiterating his strong views he had been advocating in the primaries, harping on the issues of containing the Big Pharmaceuticals, pre-existing conditions not be the criterion for turning down insurance, standing up for a Medicare type of single payer Healthcare system. Logically and from a commonsense perspective, his above arguments sound strong, reasonable, and needing immediate redressal.

Having watched Ted Cruz through lots of his primaries in the Republican nomination contest, I found his style of citing facts with statistical details, be it on waiting time for patients, number of people coming to U.S.A. for Healthcare treatment from Canada, cases in U.K. where the quality of education for some patients with specific diseases were not adequate, showing a map drawn with failures in Obamacare clearly paralleling the Republican victory in states – all revealing that he has distinctly and in a welcome way changed his style of debating with numbers, facts, and statistics in each of these. We want to put people in charge of Healthcare with your doctor and empower you is what Senator Ted Cruz’s thrust is.

Absence of any discussion on electronic patient records, e-prescriptions, websites for healthcare information, online consultancy, and interactive digital TV health advice programs in this new age have been the missing points in this debate.

Linking the fulfilment of election promise and honoring the commitment to serve the people, Ted Cruz seemed to stand the strong ground of the President is what I inferred from this debate.

“Dieu avec nous”

Wednesday, February 8, 2017 – 12. 49 p.m. (IST)

Tidbit : ” He had had much experience of physicians, and said the only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you druther not” – Mark Twain.

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