It can be a perpetual downer to read, week after week, month after month, year after year, about the health care injustices that characterize the most expensive yet most dysfunctional health care system in the industrialized world – ours. That is why it is a very refreshing break to read what our medical students are doing.
With all the talk this week about double-digit percentage increases in premiums for plans offered in the ACA exchanges, there is risk that this report my be lost in the background, though, for most Americans, this report is of far greater importance.
The point here is that, although the Affordable Care Act (ACA) did expand the percentage of people with some form of health insurance, it still leaves us worse off than other nations in the percent of individuals remaining uninsured, and it didn’t fix other problems such as impaired access to health care.
In my work, volunteering as a health policy fellow for Physicians for a National Health Program, I follow the health policy literature, including that produced by Harvard’s T.H. Chan School of Public Health. They devote much of their research to tweaking the highly flawed policies that have resulted in the most expensive health care system but one that is infamous for its mediocre performance for far too many.
This article is a great resource that explains why the Affordable Care Act has not and will not provide us with the health care reform that we need.
Interesting. When the nation is upset about the very high increases in the insurance premiums for plans offered on the insurance exchanges, CMS acting administrator Andy Slavitt says that the insurers should have started with higher premiums, and the annual premium increases should have been greater.
As Kip Sullivan explains, MACRA is bringing us considerable administrative complexity and grief without evidence that it will achieve its goal of containing costs while improving quality. You may want to use the link above to read the rest of his article, including the footnote on CMS not being forthright.
The mantra today is to pay for quality instead of quantity, and the government and private sector are rapidly moving ahead with administratively burdensome programs to implement this vision. But they left out a step. As this GAO report reveals, they have not developed a program that can adequately measure quality.
The authors note that “most physicians are not explicitly racist and are committed to treating all patients equally,” but, importantly, “they operate in an inherently racist system.” Further, “structural racism is insidious, and a large and growing body of literature documents disparate outcomes for different races despite the best efforts of individual health care professionals.”
One of the major concerns with the implementation of the Affordable Care Act is that many of the exchange plans have narrow to ultra-narrow provider networks. Since it is difficult to determine the breadth of providers included, CMS is providing a network rating system to provide more transparency, as if the problem of narrow networks wasn’t much more serious than simply lack of adequate information.
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