Tuesday, June 27, 2017

Real Healthcare Reform

(I sent this to President Trump on 06/27/2017)

Real Healthcare Reform

Mr. President, the healthcare bills proposed by the House and the Senate are not the great healthcare reforms you promised and millions of Americans need. These bills, like the Affordable Care Act (ACA), address health insurance reform, not health care reform. Until we truly reduce the cost of healthcare, it will not be affordable to many millions of Americans. There are many things we and our legislators can do to lower healthcare costs.

We can, for example, invest in medical research. Preventing diseases and finding cures or treatments will dramatically reduce healthcare costs as well as improve lives. The costs associated with Alzheimer disease is estimated to be $20 trillion in the next 40 years. It already comprises 15% of the Medicare/Medicaid budget. We can reduce the time it takes to bring new treatments and drugs to market. We can ensure that the U.S. Food and Drug Administration keeps up with modern technology. It takes an average of 17 years to bring some drugs to market. It is estimated that reducing this by 1 year may save $1 trillion. We can automate Medicare/Medicaid billing and payment systems, incorporating fraud detection algorithms now used by credit card companies. This will significantly reduce the $100-$300 billion lost annually to fraud.

The most important and most immediate way to reform healthcare is to rethink how we view disability. We must stop viewing people with disabilities as unhealthy and unable to work. We must recognize that expenses related to long-term disability enable people with disabilities to live full and productive lives in their community and are not healthcare costs. As an example, most people with long-term disabilities who use personal assistant services to get out of bed in the morning do so not because they are unhealthy, but because they plan to be active that day. We should establish a new Community Independent Living Fund to pay for such things as personal assistant services, on-going therapies, durable medical equipment and maintenance drugs for people with long-term disabilities. Extracting costs associated with these goods and services should significantly lower premiums and costs associated with pre-existing conditions. It will also enable millions of people with disabilities to leave Social Security rolls without fear of losing services they desperately need to survive. Please see Community Independent Living Fund for more information.

As background, I am a person with Cerebral Palsy. I have a significant speech impairment. I use a powered wheelchair and I use personal assistant services for many of my activities of daily living. My wife, who also has Cerebral Palsy, and I live in our own home in Oakland, California We have a great son who is now 30 years old. I have always been quite healthy – knock on wood. After 29 years of working at Wells Fargo, I retired as a Sr. Vice President from their IT area to start a disability-focused employment company that specializes in consulting on staffing and placement issues.

These are only a few of the many ways we can lower healthcare costs while significantly improving the lives of millions of Americans. Rather than reforming health insurance, now is the time to work together to truly reform healthcare in a bi-partisan fashion, taking advantage of technology, medical breakthroughs, and innovations. Now is the time to expect all Americans to live up to their potential by providing them with products and services needed to succeed. Let's not squander this time. Let's truly make America greater. Please let me know how we can move these ideas forward.

Go! Go! Go!

Neil Jacobson



  1. Thank you for so articulately and personally communicating with Mr. Trump. These are well thought out suggestions. I am not convinced that the president is intending to improve the lives of the millions of Americans that deserve effective health insurance. Time will tell..

  2. Well stated! As a vocational rehabilitation business specialist (aka employment coordinator) with a State VR department I agree. MOST people with disabilities want to work and the continued higher level of unemployment for people with disabilities is actually a form of discrimination which is unfortunate particularly with the assistive technology available (usually at little or no cost to the employer). Keep on truckin!