Health Chaos Ahead [View all]
I knew the ACA was way too complicated. Whatever happened to common-sense K.I.S.S.?
The comments on this NYTimes article below are more interesting.
Health Chaos Ahead
By DAVID BROOKS NY Times
It was always going to be difficult to implement Obamacare, but even fervent supporters of the law admit that things are going worse than expected.
Implementation got off to a bad start because the Obama administration didnt want to release unpopular rules before the election. Regulators have been working hard but are clearly overwhelmed, trying to write rules that influence the entire health care sector an economic unit roughly the size of France. Republicans in Congress have made things much more difficult by refusing to provide enough money for implementation.
By now, everybody involved seems to be in a state of anxiety. Insurance companies are trying to put out new products, but they dont know what federal parameters they have to meet. Small businesses are angry because the provisions that benefited them have been put on the back burner. Health care systems are highly frustrated. They cant plan without a road map. Senator Max Baucus, one of the authors of the law, says he sees a huge train wreck coming.
Ive been talking with a bipartisan bunch of health care experts, trying to get a sense of exactly how bad things are. In my conversations with this extremely well-informed group of providers, academics and former government officials, Id say there is a minority, including some supporters of the law, who think the whole situation is a complete disaster. They predict Obamacare will collapse and do serious damage to the underlying health system.
But the clear majority, including some of the laws opponents, believe that were probably in for a few years of shambolic messiness, during which time everybody will scramble and adjust, and eventually we will settle down to a new normal.
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COMMENTS
Aaron WaltonGeelong, Australia NYT Pick
Writing as an American-trained physician (Duke Med '99) who has spent the past decade working in Australia's high-quality, free, public hospital system, I would suggest that the degree to which A.C.A implemention is or will be "shambolic," is a direct function of the degree to which America's existing system for allocating health care resources is a shambles and the degree to which the A.C.A. retrained many of the worst, least efficient aspects of the dual public/private medical insurance system.
Until America abolishes private health insurance and fee-for-service reimbursement and establishes a system of publically owned and operated hospitals and clinics staffed with salaried professionals who have no financial stake in the quantity of treatment they prescribe, America will continue to have uselessly high-cost, unevenly distributed health care, frustrated patients and practitioners and mediocre outcomes.
April 26, 2013 at 6:00 a.m.RECOMMENDED441
Jean-Francois BriereAlbanyNYT Pick
Medicare for all would be so much easier to implement. Why try to build such a mindboggingly complicated edifice when we already have a system in place ready to insure everybody?
April 26, 2013 at 6:10 a.m.RECOMMENDED475
http://www.nytimes.com/2013/04/26/opinion/brooks-health-chaos-ahead.html?src=recg