The Journal of the American Medical Association recently published an article by President Obama (a first for a serving US president I think!) in which he reviewed the achievements of the Affordable Care Act (‘Obamacare’) and the next steps for this initiative.   

It’s certainly worth a read if you have an interest in the US health-care debate as it’s essentially a pitch to a key health-care audience – US doctors. 

In the article, the president gives useful insight into the challenges for health care, and provides a platform from which presidential hopeful Hillary Clinton could take her lead. Three key lessons are highlighted:

 

  1. Implementing change in the US health-care system is difficult.
    This is a key point, particularly as change is made especially tricky in the face of ‘hyperpartisanship’. Current consensus expectations are for a Democrat president, but for a tied Congress in which neither Democrats nor Republicans control both the House and the Senate. If this is the case, the next president will need to put some major effort into wooing Congress to develop an effective working relationship on health care.   
  1. Special interest groups pose a continued obstacle to change.
    The pharmaceutical industry gets a special mention, but Hillary Clinton has also singled out health-insurance providers as another group worthy of mention in her recent election commentary.  In my view, a future president will achieve more by working with these groups rather than against them.
  1. Taking a pragmatic approach in both legislation and implementation is important.  
    Keep it simple and you have a greater chance of getting something done. However, as the recent history of health-care reform has shown us, there are no guarantees.

 

With Bernie Sanders now formally endorsing Mrs Clinton as the presidential nominee, it is likely she will have a clear run at the Democratic National Convention in late July. However, Senator Sanders is thought to be seeking the chairmanship of the Senate Health Committee as a ‘quid pro quo’, which would ensure health care continued to be a topic of discussion for politicians and investors well beyond the November US presidential election.

The implications for health-care investing are clear. Despite the recent political commentary, changes to the US health-care system can only be gradual, whoever sits in the Oval Office after President Obama.

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