When it comes to who healthcare executives want to see win the upcoming presidential election, it seems they are nearly as divided as average Americans.
In a recent survey by healthcare consulting firm Advis, about 46% of healthcare executive respondents said they believe a President Donald Trump and Vice President Mike Pence administration is better for the future of healthcare in the U.S. In comparison, just over 41% of the 130 executives who responded to the survey said they thought a win by former Vice President Joe Biden and California Sen. Kamala Harris would be better for the industry.
About 13% said they were still undecided in the survey, which was conducted in mid-September. (Note: That was before the first presidential debate, before the death of Supreme Court Justice Ruth Bader Ginsburg and before Trump was diagnosed with COVID-19.)
And, should Trump and Pence win a second term, executives said the policy changes they most expect to see include the further dismantling of the Affordable Care Act (75%) and increased efforts to control prescription drug costs (59%).
But, if Biden and Harris were to win, they most expect to a see a Medicare-for-All type of coverage with opt-out options for commercial plans (73%) as well as further strengthening of the ACA (69%).
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"The politics of our nation were really starkly represented here when you look at these two questions," Advis CEO Lyndean Brick told Fierce Healthcare."You've got CEOs or C-suites really splitting the difference just like we do across the country. They're divided, and they think very differently on these matters."
The most illuminating message from the findings is executives have clear regulatory expectations they are preparing for depending on how the election swings.
"While many of the executives were glad prices would be controlled, they were very concerned about undermining the 340B program because the 340B program represents significant savings to cash-strapped hospitals," she said. That was a major concern by 60% of the people.
For instance, if Trump and Pence prevailed in November, only 20% of the industry executives did not expect any increased scrutiny for mergers and acquisitions and most did not believe there would be any additional consumer safety protections or push for Medicare for All, Brick said. But the majority indicated they expected to see growing inequality of care and increasing concerns about access and transparency. "They were concerned the efforts by the Trump administration to date regarding transparency are going to cost the systems significant funds without any real gain in consumer protection," she said.
On the flip side, if there were a Biden-Harris win in November, executives indicated they thought shifts toward a Medicare-for-All model would be very realistic, Brick said. "I remember doing a similar survey just two years ago about the prospects of Medicare for All, and there was nowhere near that level of confidence," she said. Another 44% anticipate there will be more legislation protecting consumers and patients and a little more concern (33%) that there could be more scrutiny around mergers and acquisitions. "It's almost the mirror opposite," Brick said. "The comments from providers throughout this whole survey were really insightful. They said things like 'they really feel there's going to be an increase in regulatory burden for providers and insurers under Biden and Harris.'"
But likewise, she said, they indicated they thought there would be a greater focus on individuals who need healthcare and that access and quality would be improved, she said.