Abstract In the Bloomberg article, “Hospitals Still Face anUgly, Uncertain Future,” Max Nisen (2017) discusses the potentially devastating impact that the passage of the American Healthcare Act, or “Trumpcare,” could have on the healthcare industry in the United States, and on the wider economy. Of major concern is the fact that 23 million Americans stand to lose their health coverage if the American Healthcare Act is implemented, as well as the mandates that $800 billion USD will be slashed from the Medicare budget. Besides the public health issues that this entails, it could also wreak major havoc on the United States economy. If history is any indication, uninsured Americans do not simply raid their savings accounts to pay for healthcare, but instead refrain from seeking treatment at all, and this could limit the demand for healthcare services across the United States.

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Summary and Main Points of Article
In the Bloomberg article, “Hospitals Still Face an Ugly, Uncertain Future,” Max Nisen (2017) discusses the potentially devastating impact that the passage of the American Healthcare Act, or “Trumpcare,” could have on the healthcare industry in the United States, and on the wider economy. Of major concern is the fact that 23 million Americans stand to lose their health coverage if the American Healthcare Act is implemented, as well as the mandates that $800 billion USD will be slashed from the Medicare budget. Besides the public health issues that this entails, it could also wreak major havoc on the United States economy. If history is any indication, uninsured Americans do not simply raid their savings accounts to pay for healthcare, but instead refrain from seeking treatment at all, and this could limit the demand for healthcare services across the United States.

As Nisen (2017) has also mentioned, insurers who receive the bulk of their funding from the Federal government via the Medicaid program stand to be negatively impacted, as well. Indeed, many of these companies will likely be forced to shut down, should the American Healthcare Act become law in 2018. While President Trump and his supporters are insistent that the proposed healthcare reforms will ultimately benefit the economy by slashing Federal expenditures, that scenario is highly unlikely. Should the American Healthcare Act become law, the demand for healthcare services will drop, as healthcare consumers will hesitate to see the doctor for minor illnesses, and will be more likely to wait until a more serious condition, such as a heart attack, arises before they seek medical care. Often, in these cases, uninsured patients cannot afford to pay, and enter into bankruptcy, leaving healthcare providers with an unpaid bill.

Implications for United States Economy
If the American Healthcare Act becomes law in 2018, the effects will immediately reverberate throughout the United States economy. If, as Nisen (2017) predicts, 23 million Americans become uninsured, that means 23 million fewer potential consumers of preventive healthcare services will be available. When people do not have health insurance, they simply stop going to the doctor for preventive care services, and tend to rely on the services of area emergency rooms when they have a serious health issue (Ubel, Comerford & Johnson, 2015). In such scenarios, it is often the case that patients, once treated, cannot afford to pay the enormous hospital bills, and so enter into default, or simply file for bankruptcy protection, which leaves healthcare organizations in a serious bind if they are unable to collect on past due debts.

In addition to the decline in demand for healthcare services, there will also be a precipitous decline in the market for mental health and behavioral care services, which will not be covered under the auspices of the American Healthcare Act. Not only will this result in declining revenue for such healthcare providers as psychiatrists, psychotherapists, and chemical dependency treatment centers, but the larger impact of untreated mental illness is widely known (Ubel et al, 2015). When mentally ill individuals cannot afford treatment, they often become highly dysfunctional, and as such, become far less effective and productive employees. Ultimately, such individuals may lose their jobs and thus be required to apply for public assistance. Moreover, untreated mentally ill individuals also place a strain on other public services, such as law enforcement, emergency personnel, and social service case managers. Indeed, when it comes to mental illness, it is usually more cost effective to treat the person with medication and counseling, rather than to await the consequences of their behavior.

Finally, a loss in health coverage by millions of Americans has other reverberating effects on the United States economy. When uninsured people do not feel as though they can afford to go to a doctor for a routine treatment, they simply call out sick from work, and hope that they can sleep away the illness. Thus, the passage of the American Healthcare Act will more than likely result in increased absenteeism from the American workplace, which then results in lost productivity. Further, if uninsured Americans cannot receive routine preventive care services for conditions such as diabetes and hypertension, their conditions usually worsen to levels that take them out of the workforce for extended periods of time, or remove them from the labor force altogether.

Conclusion
In regards to the assertion of Max Nisen (2017) that the American Healthcare Act has the potential to do a great deal of damage to the United States economy, I would have to state that I agree. If 23 million Americans are to suddenly find themselves without health insurance, they will simply stop using the services of healthcare providers, unless they absolutely need them. In such emergency cases, uninsured individuals usually take advantage of the local emergency room, and become a drain on the budget of local hospitals (Popescu, 2014). Moreover, an unhealthy workforce is not a productive workforce, and as such, the consequences of the potential passage of the American Healthcare Act could remain with our nation for decades to come, long after the Trump Administration has left office. While the Trump Administration insists that a streamlined healthcare plan, and the gutting of Medicare, will save the nation money and help to reduce the Federal deficit, this assertion seems to be highly dubious. If the American Healthcare Act passes in 2018, it will be highly destructive to the United States economy.

    References
  • Nisen, M. (2017, May 26). Hospitals Still Face an Ugly, Uncertain Future. Bloomberg.com. Retrieved from https://www.bloomberg.com/gadfly/articles/2017-05-26/hospital-insurer-stocks-and-ahca-still-an-uncertain-future.
  • Popescu, G. H. (2014). Economic aspects influencing the rising costs of health care in the United States. American Journal of Medical Research, 1(1), 47-47.
  • Ubel, P. A., Comerford, D. A., & Johnson, E. (2015). Healthcare. gov 3.0—Behavioral economics and insurance exchanges. New England Journal of Medicine, 372(8), 695-698.