Seeing Covered California executive director Peter Lee and California Health and Human Services Agency Secretary Diana S. Dooley having breakfast last week at Fox & Goose, I congratulated them on California's successful rollout of the Affordable Care Act. Over the last several months, the state has signed up more than a million residents for health insurance through Covered California, and an additional 1.5 million through Medi-Cal.
Dooley thanked me, then said something like, “It helps to be graded on a curve.”
Other states have had more problems. While the rollout in California may not have been smooth, it was historic—significantly increasing the number of insured Californians in a very short time. Many families who were previously unable to receive medical treatment have been helped tremendously.
But the ACA is not just about providing health insurance for those who did not have it before. The ACA is designed to completely overhaul the United States health-care system. Why? If we don’t fix the health-care system, our economy is doomed.
The United States cannot compete in the world market unless we fix our health-care system. We are already spending nearly 18 percent of our gross domestic product on health care. Other industrial countries spend between 6 and 12 percent. Despite paying significantly more, we have more uninsured people and worse health outcomes. And as if that’s not bad enough, baby boomers, despite their protests, are aging, putting more strain upon the health-care system. The system is broken.
In an interview I had with Dooley in August 2012, she talked about the three-legged stool of the ACA: The first leg being extended coverage, the second being the reduction of costs and the third being more emphasis on prevention.
The ACA has a wide array of cost-saving reforms that will transform our health-care system. Paying for outcomes instead of incentivizing doctors to perform often needless procedures, opening health clinics that will allow us to provide more cost-effective health care, increasing the percentage of general practitioners and decreasing the number of specialists, improving record-keeping, expanding job responsibilities of nurses and nurse practitioners, and many other much-needed reforms.
Implementing these reforms will be difficult. Why? Because every dime saved by reform is a dime out of someone’s pocket. A pocket that is usually attached to a very nice suit. These suits are worn by the lobbyists and political donors who will do everything in their power to protect that dime and that suit.
The future of our economy and the health of our citizens is dependent upon the successful implementation of the ACA reforms. These reforms should be debated. They could be improved. But it is irresponsible to attack the ACA without presenting an alternative to the current system. Our current system will undoubtedly bankrupt our government and our economy, while providing inferior health care compared to other countries.
