How healthcare will change under Trump — injecting standard business principles into healthcare delivery: Q&A with Dr. Craig Callewart


Craig Callewart, MD, is a private practice surgeon in Dallas who has participated in politics at the local and national level for years.


He is active in healthcare matters and serves on Congressman Pete Sessions’ Healthcare Task Force, the House sponsor of the Sessions-Cassidy bill to repeal the ACA. He can be reached at


Question: Dr. Callewart, how would you summarize the current healthcare situation?

Dr. Craig Callewart: In contradistinction to media reports, I would like to point out that healthcare remains the same. We are struggling with a broken payment system, and it clearly is in chaos. The American public was spared the most egregious parts of the ACA, which were set to start clicking in place after the inauguration. That said, the drastic increases in premiums and deductibles in 2017 are the industry’s way to try to recover the massive losses sustained by the major carriers in managing/underwriting the Affordable Care Act. They were expecting Congress to cover those losses, and when defunded, are now passing these losses on to the premium payers.

Q: Are the Republicans really going to dump the ACA?


CC: Probably not. The ability to keep dependent children on their parents' plans until age 26 is very popular, as is the ability to have pre-existing conditions covered by a new insurance. These are expensive benefits, as the actuaries depend on young people producing more premium revenue than they consume and expect a long period of premiums to cover pre-existing conditions. The Republican goals are to make health insurance more closely mirror home-owners insurance and automobile insurance — paid by the consumer, portable, and more affordable. That will require reworking the tax code, which is why Mr. Trump has said the two are closely related, and will be addressed together.


Q: Dr. Callewart, you recently attended the swearing in, inauguration and associated events on The Hill. What was your experience?


CC: It was like nothing I've seen in the 15 years I have served organized medicine. Clearly, we are in a new era with our previous “way of doing business” in Washington gone. The feeling is to interject “standard business principles” into the way healthcare is delivered. Accordingly, it is my perception that physician owned-hospitals and outpatient facilities will be allowed to expand and provide more competitive options for consumers.

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