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Wednesday, July 20, 2016

Some perspective on the Affordable Health Care Act's results

      There is a lot of noise about how the Affordable Care Act is a failure and needs to be repealed and replaced.  The rhetoric is not supported by the facts.   In a recent Journal of the American Medical Association here is what their findings were:

"Findings: The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care. Since the Affordable Care Act became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, primarily because of the law’s reforms. Research has documented accompanying improvements in access to care (for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5.5 percentage points), financial security (for example, an estimated reduction in debts sent to collection of $600-$1000 per person gaining Medicaid coverage), and health (for example, an estimated reduction in the share of nonelderly adults reporting fair or poor health of 3.4 percentage points). The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain.

Conclusions and Relevance: Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs. Although partisanship and special interest opposition remain, experience with the Affordable Care Act demonstrates that positive change is achievable on some of the nation’s most complex challenges.

    The next big improvement to our health care system is to bring back a public option that will provide and alternative to private providers and improve cost control of health care spending.  This improvement was lost in the Senate by only a single vote in the effort to gain closure of the Republican filibuster against the bill.   It is doubtful that the Congress will go along with bringing back this option as long as the Republicans are in control but eventually we will achieve more aspects of a single payer system in spite of political opposition from conservatives.



edblisa said...

Isn't it a shame that the health of human beings has become a political fight? I believe that a change was needed so that more Americans could have access to healthcare, but what it has become is a huge political mess. Health care insurers and Big Pharma are big political donors and don't want to see their profits stabilize or dwindle, yet it is fine for middle class Americans to offset the cost of 'healthcare for all' by having to pay larger deductibles and more for the plans yet get less coverage overall? There is no easy answer to any of this, but it seems that maybe the advice of actual physicians working in the trenches would be a good way to garner some insight into the problem. Instead, what continues to happen is that the rich get richer by supporting campaign funding, the middle class is dwindling, and the old and poor are thrown a bone.

duanestclair said...

I agree that the interests of health care insurers and "big pharma" have forced any reform efforts to make compromises that hurt the reform efforts. Our politics are so divided that it provides an opportunity for special interests to pay off enough elected officials to prevent any reforms that threaten their industries. The reform efforts during the debates on the Affordable Health Care Act were largely from the Republican members of Congress.