United States Health Care Reform Progress to Date and Next Steps
Barack Obama, JD
Abstract
Importance The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care.
Objectives To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act.
Excerpts from the Article
“At the same time, a broad array of health care organizations and professionals, business leaders, consumer groups, and others agreed that the time had come to press ahead with reform.19Those elements contributed to my decision, along with my deeply held belief that health care is not a privilege for a few, but a right for all.”
…
” Since 2010, more than 10 million Medicare beneficiaries have saved more than $20 billion as a result.”
…
“While the Great Recession and other factors played a role in recent trends, the Council of Economic Advisers has found evidence that the reforms introduced by the ACA helped both slow health care cost growth and drive improvements in the quality of care.44,52 The contribution of the ACA’s reforms is likely to increase in the years ahead as its tools are used more fully and as the models already deployed under the ACA continue to mature.”
…
“while the ACA has greatly improved the affordability of health insurance coverage, surveys indicate that many of the remaining uninsured individuals want coverage but still report being unable to afford it.53,54 Some of these individuals may be unaware of the financial assistance available under current law, whereas others would benefit from congressional action to increase financial assistance to purchase coverage, which would also help middle-class families who have coverage but still struggle with premiums.”
…
“Simpler approaches to addressing our health care problems exist at both ends of the political spectrum: the single-payer model vs government vouchers for all. Yet the nation typically reaches its greatest heights when we find common ground between the public and private good and adjust along the way. That was my approach with the ACA. We engaged with Congress to identify the combination of proven health reform ideas that could pass and have continued to adapt them since. This includes abandoning parts that do not work, like the voluntary long-term care program included in the law. It also means shutting down and restarting a process when it fails.”
Corresponding Author: Barack Obama, JD
Additional Contributions: I thank Matthew Fiedler, PhD, and Jeanne Lambrew, PhD, who assisted with planning, writing, and data analysis. I also thank Kristie Canegallo, MA; Katie Hill, BA; Cody Keenan, MPP; Jesse Lee, BA; and Shailagh Murray, MS, who assisted with editing the manuscript. All of the individuals who assisted with the preparation of the manuscript are employed by the Executive Office of the President.
*[ZA Editor’s note: This is a paper submitted to an academic journal, and by President Barack Obama JD, haven been acclaimed the first by a sitting President of the US, of which the effects are remarkably positive- as now more expanded interest on matters of Medical ethics and law, health care and the political implications of rationing vis a vis distributive justice, and human rights. And then economic policy. In four weeks since July 11, on JAMA it has seen about 1.1 million views, creating massive opportunities for contribution and considerable attention, especially from research experts in these areas. Is this a clue for other nations, who may need to, to revisit legislations on healthcare, for better financial savings and improved coverage for patients? Is this a further step [for others to expand on rather than retract] towards ensuring more reforms for the uninsured, who are unable to pay for premiums, increased responsibilities and benefits for all stakeholders, and creating more concrete foundations for protecting human rights objectives both for citizens of a nation and immigrants?
It seems to me purpose has been served.
To download full paper- http://jama.jamanetwork.com/mobile/article.aspx?articleid=2533698] Citation: JAMA. 2016;316(5):525-532. doi:10.1001/jama.2016.9797.
