I naively believed that following the recent presidential election, controversy over the Affordable Care Act (ACA) would abate. My wife, who was opposed to ObamaCare and, like me, enjoys reading The Wall Street Journal, never fails to point out articles critical of the ACA. For example, she asked me if I had read an op-ed piece by Daniel Kessler, “ObamaCare’s Broken Promises,” in the Feb. 1 issue of the WSJ. I had read it and when she asked for my reactions, I shrugged.
Why did I respond to my wife in that way? The four broken promises cited by Kessler were:
- Lower healthcare costs
- Smaller deficits
- Preservation of existing insurance
- Increased productivity
I guess the reason I shrugged was that the payment source for roughly 30 million Americans, which accounts for around 90 percent of all ACA spending, won’t kick in for another year. Almost everything in the article was speculative. And as is true with most op-ed pieces, there is nothing about the positive aspects of the ACA.
On this point, most of the criticism of the ACA focuses on its costs. It is like doing a cost-benefit analysis and ignoring the benefits.
After years of attending three-day health policy conferences sponsored by the Colorado Health Foundation, I have come to agree with many speakers that providing a payment source for the uninsured is a good idea, not just for these people but also for the healthcare provider community. I assume that is why the American Hospital Association committed to a $155 billion give-back (over 10 years); that is one of the rarely mentioned sources of funding for the ACA.
Here are a few other parts of the ACA (which I read in its entirety shortly after it passed in March 2010) that are never mentioned by critics:
- Five initiatives promoting primary care
- Encouragement of accountable care organizations (e.g., CMS Shared Savings plans)
- Support for the development and use of clinical guidelines
- Encouragement of innovation in the delivery of care
- Several billions of dollars for federally qualified community health centers that already serve the poor and uninsured
When I read an op-ed piece critical of the ACA, I would at least like to see some mention of the potential benefits. There is no doubt in my mind that the ACA has numerous flaws, but don’t these need to be balanced against its positive aspects?
Dean C. Coddington is a senior consultant, McManis Consulting, Denver, and a member of HFMA’s Colorado Chapter.
Publication Date: Friday, February 15, 2013