Will the “ACA” work? You Decide!

by | Sep 1, 2013 | Healthcare, Reflection

Lots of folks have been asking me lately what I think about the “Affordable Care Act” (ObamaCare). I’ll let you form your own opinion. First, a little lesson from the history of Medical Economics:

In the Eighties, a form of insurance payment took hold, first in Medicare, then in Private Insurance, to control escalating expenditures in healthcare. It is called Managed Care.

The premise of Managed Care is that by tracking diagnoses and services (through all those “CPT” and “ICD” codes) and establishing contracted fees between insurance networks and providers, healthcare costs can be contained. In other words, by creating a central administrative control mechanism, the payer (Insurance, Medicare, etc.) can protect you, the patient, from the unreasonable prices of the provider (that’s me). You’ve seen how clearly the insurance companies are looking out for you every time you see an “EOB” (Explanation of Benefits) from your insurance carrier or from Medicare.

Did anyone see a reduction in healthcare inflation in the last 20 years? Come to think of it, does central control ever work as a way of controlling a complex economy? And did you know that every element of your healthcare information goes into a central reporting and sharing system (the Medical Information Bureau – “MIB” – the real “Men In Black”) with every claim that is filed?

The ACA is supposed to fix things and make healthcare more affordable and accessible. Now we are going to let the government be the administrator of our healthcare expenditures and our private healthcare information. I trust government administration, don’t you?