Kaiser Health News, March 19, 2020
Julie Rovner: Now it’s 10 years later, the law is more popular than ever. And yet there are still some big problems in the nation’s health care system, including levels of cost sharing, surprise bills, so that even people who do have insurance are worried about costs when accessing care. Why didn’t the Affordable Care Act fix everything?
Kathleen Sebelius: Frankly, it probably would have been better to be a government takeover of health care. We got blamed for it. And yet we really didn’t do that. We ran most of this through the private system. So costs are still blossoming out of control. We’ve talked about how the public option would have been a lever for that, which we don’t have. Surprise billing wasn’t even an issue until investment bankers began buying specialty practices and figuring out, Oh, there’s a new way to make money.
And, I also think, often the Affordable Care Act is blamed for employers shifting massive costs onto their employees in employer-based health care plans, which weren’t really tampered with by the Affordable Care Act. That was always to be left alone. So we own all the bad.
‘A Monumental Effort’: How Obamacare Was Passed
The Commonwealth Fund, March 20, 2020
Liz Fowler: So, as much progress as we made with the Affordable Care Act in covering 20 million people, we still have almost 30 million who don’t have coverage. And those with coverage I think are seeing really large out-of-pocket costs. So I think we’re at a point now where we need to look and hopefully decide together what direction we want to go to continue to make progress on this road to universal coverage. With the ultimate goal, getting people covered with something they can afford that gives them the care that they need at the time they need it.
By Don McCanne, M.D.
Ten years into the Affordable Care Act and it is clear that we still have severe deficiencies in our health care financing system in spite of funding it with a very generous $4 trillion. People are still facing financial hardship and even bankruptcy, and many others are exposed to unnecessary physical suffering and even death because of access barriers that were not removed by the legislation.
It is instructive to hear from two of the most important individuals involved in the creation and implementation of ACA. Kathleen Sebelius says, “it probably would have been better to be a government takeover of health care.” Liz Fowler says the ultimate goal should be “getting people covered with something they can afford that gives them the care that they need at the time they need it.”
Well, we don’t need a government takeover of health care, but we do need a government takeover of health care financing if we really want people to have affordable care that they need at the time they need it.
Patching the current financing system and adding a public option will never get us there. We really do need single payer Medicare for All.
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