Tag Archives: Patient Protection and Affordable Care Act

HOW HEALTH REFORM CAN WORK: PART 5

THE CHALLENGE
Despite deep flaws that will have to be corrected, the Patient Protection and Affordable Care Act (ACA) has three aspects that make me optimistic about medical entrepreneurs being able to surmount the law’s barriers and create a consumer-dominated, market-based system of medical care and health insurance that will ultimately deliver high-quality, affordable medical care to everyone:
1.    The creation of consumer value
2.    The rise of high-value local health plans
3.    The achievement of effective disease prevention

Recap
In Part 2, I discussed the creation of consumer value as an unplanned result of ACA’s forcing individuals—and not their insurers—to pay for their normally consumed medical services. In Part 3, I described how new local health plans built around these providers will be able to displace national PPO-based carriers by creating a virtual cycle of ever higher medical quality and constantly improving affordability. In Part 4, I addressed how these innovative health plans can dramatically move the needle on effective disease prevention. In this concluding installment, I’ll talk about the challenges facing the innovators who will be responsible for achieving these benefits.

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HOW HEALTH REFORM CAN WORK: PART 4

A REAL FIX FOR PREVENTABLE DISEASES

Despite deep flaws that will have to be corrected, the Patient Protection and Affordable Care Act (ACA) has three aspects that make me optimistic about medical entrepreneurs being able to surmount the law’s barriers and create a consumer-dominated, market-based system of medical care and health insurance that will ultimately deliver high-quality, affordable medical care to everyone:
1.    The creation of consumer value
2.    The rise of high-value local health plans
3.    The achievement of effective disease prevention

In Part 2, I discussed the creation of consumer-value as an unplanned result of ACA’s forcing people—rather than insurers—to pay for their own normally consumed medical services. In Part 3, I described how new local health plans built around these providers will be able to displace national PPO-based carriers by creating a virtuous cycle of ever higher medical quality and constantly improving affordability. In this fourth of five installments, I address how these innovative health plans can dramatically move the needle on effective disease prevention.

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HOW HEALTH REFORM CAN WORK: PART 1

Part 1: Even a Blind Pig Finds an Occasional Truffle

I’ve made no secret of my disdain for the Patient Protection and Affordable Care Act (ACA), the new health reform law. It is a bad bill that focuses the wrong “solutions” on the wrong problems and promises to visit unnecessary economic distress and destruction on America’s providers, consumers, taxpayers, and insurers. Even the IRS is protesting.

Yet, rather than continue to bash it, I’ve taken my summer hiatus from writing this blog to focus on a more constructive approach. The law is a fact we have to deal with, and despite a lot of talk about a subsequent Congress overturning it, I’ve concluded such an action to be both unlikely and unwise. The opposition has nothing better on the table and the ACA situation is actually far from hopeless. The focus needs to be on repairing, not revoking it.

Posted in Government vs Markets, Health Costs, Health Insurance, Medical Quality, Prevention | Tagged , , , , | 3 Comments

WHICH WAY WILL OBAMACARE BEND THE MEDICAL COST CURVE?

We know that more than half of all medical cost is wasted, adding no value to the patient. We also know that the total costs of medical provider billing, collection, and payment consume as much as 30% of every health care dollar—about ten times the transaction costs in every other industry. If medical care were as efficient as, say, our economy’s food sector, it would provide higher quality for a third of today’s $2.6 trillion cost and free up $1.7 trillion every year for higher wages, lower federal deficits, and a major boost in job-creating private-sector investment.

Moreover, 75% of all medical spending now goes to treat preventable chronic diseases. If we could figure out how to get people to stop eating, drinking, and smoking themselves to death, and cut out the wasteful spending, our total medical bill would plummet to only 10-20% of today’s level.

Posted in Health Costs, Health Reform Goals, Prevention | Tagged , , , , | 3 Comments