On November 3, 2020, Americans will finish casting their votes in what may be one of the most pivotal elections in U.S. history.

It could be days or weeks before the final outcome is clear, but when a historic level of votes are finally all counted the results will determine the future of healthcare in this country for decades.

The differences between the two parties and their approach to healthcare is what is on the ballot in 2020 — will healthcare become a “right” or a “privilege” for Americans?

Here are five predictions for the future of healthcare in America that will play out over this decade:

1. Healthcare Hunger Games: Universal-Healthcare/Medicare-for-All will either establish its foundation in a hybrid ACA/Medicare/Medicaid model with a Biden victory, or it will continue under constant assault from all sides with a Trump victory. The outcome of the election will decide whether or not we enter into a divisive period of history between the haves and have-not’s resembling “The Healthcare Hunger Games.”
2. Aging Population: America’s population of 65+ will grow to the point that it surpasses the population of 18 and under in less than fifteen years. A mass exodus of retiring workers will shrink the tax base to support them in retirement exerting even more stress on already beleaguered entitlement programs. Increasing demand on Medicare and Medicaid will fuel growth in private pay resources such as reverse mortgages and life settlements to cover the costs of senior care supports and services.
3. Entitlement Reforms: Despite attempts to scapegoat entitlements for ballooning budget deficits and the national debt, the reality of these programs’ importance to millions of Americans will trump political demagoguery. Meaningful reforms to shore up the fiscal solvency of Social Security, Medicare and Medicaid will continue.
4. Employer Health Coverage: Employer based health coverage only works when people are employed. 158 million people (more than half of all Americans under the age of 65) had employment based (group) health insurance at the beginning of 2020. But today, 40 million people suddenly found themselves unemployed due to the Coronavirus outbreak. Employer based health insurance has been the primary means to cover Americans, but re-defining what “employment” looks like going forward will have to take into account on overreliance on a stable and growing economy as the primary way for people to obtain affordable health insurance coverage.
5. Exhausted Care Providers: Medical staff and supplies stretch thin quickly during a crisis, and the impact of Coronavirus on healthcare will be long-lasting. The inequities of healthcare across economic and racial lines will need to be addressed, and the debate over how healthcare is paid for will only get more intense. The need for more medical professionals and also overall support staffing will become a problem as many will question if this is a field they want to be in. The shortages of supplies forcing hospitals to crowdsource for things such as homemade masks have shown how important preparedness is and the need to stockpile materials.

A nation’s healthcare system reflects its values, and the outcome of this election will be a lasting statement of this truth that will impact every single American.

Chris Orestis, President of LifeCare Xchange and known as the Retirement Genius, is a nationally recognized senior care advocate and expert in retirement, long-term care and specialty senior living funding solutions. The author of two books, numerous published papers and articles, and a frequent industry speaker; he is the innovator that brought the LTC Life Settlement into the market over a decade ago.