Robert B. Doherty, BA
Doherty RB. The Certitudes and Uncertainties of Health Care Reform. Ann Intern Med. 2010;152:679-682. doi: 10.7326/0003-4819-153-1-201007060-00235
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Published: Ann Intern Med. 2010;152(10):679-682.
The Patient Protection and Affordable Care Act (PPACA) of 2010 was signed into law by President Obama on March 23. This legislation has elicited much debate among policy experts and the public alike. No one knows exactly how this new complex law will play out, and objective evaluation of its effects is important. The American College of Physicians hopes that the legislation will advance key priorities on coverage, workforce, and payment and delivery system reform. The goal of the PPACA is to help provide affordable health insurance coverage to most Americans, improve access to primary care, and lower costs. This article discusses what the chances are that it will accomplish these objectives. It also explains many of the key provisions in the legislation and how they will affect both physicians and patients. Despite considerable uncertainty about the effects of this act, when compared with the status quo, it is an extraordinary achievement that will continue to evolve through its implementation.
Even with highly optimistic assumptions, health spending remains out of control. It absorbs more of government, business and family budgets. Higher health spending would put pressure on future budget deficits, already projected to total about $9 trillion over the next decade. If new taxes and Medicare “savings” are real, they could be used exclusively to pay down deficits, not finance new spending. (16)
I'm sort of a known skeptic on this stuff. My summary is it's really hard to figure out how to bend the cost curve, but I can't think of a thing to try that they didn't try. Everything is in here. I can't think of anything I'd do that they are not doing in the bill. You couldn't have done better than they are doing. (17)
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