By Michael R. McGarvey
It's high time for people who know something to speak up. Six months ago today, Congress passed and President Obama signed the Affordable Care Act, the most ambitious and far-reaching reform of the health-care system in 45 years. In the months since that historic accomplishment, the public has been subjected to a relentless barrage of know-nothing, self-interested negativism from politicians and interest groups funded by the insurance industry, and the polls show voters are taking it seriously.
In the run-up to the reform vote, House Minority Leader John Boehner repeatedly crowed that the U.S. health-care system is "the best in the world." That is simply false. On every measure used to assess the effectiveness of health-care systems, the United States is outranked by more than 30 other nations. The first step to improvement is to recognize the problems.
I am a physician, and I spent 16 years of my career in and around the health-insurance industry, and I think the health-reform law is a huge step in the right direction.
Let's consider what the law has already accomplished: Roughly four million Medicare beneficiaries who have hit the "doughnut hole" in their drug coverage are getting $250 rebates this year, along with a 50 percent discount on prescription drugs; a temporary reinsurance program was established to protect early retirees; and a temporary high-risk insurance pool was created to help Americans who are uninsured because of preexisting conditions.
Beginning today, a number of key provisions go into effect: No health plan will be able to continue the practice of dropping a person who gets sick; lifetime caps on coverage will be prohibited; annual coverage limits in many plans will be tightly restricted; most health-insurance plans will be prohibited from denying coverage to children with preexisting conditions; young people up to their 26th birthday will be able to remain on their parents' insurance policies; and new plans will be required to cover preventive services without imposing co-payments or deductibles.
Wisely, the authors of this extensive health-reform law phased its implementation over four years. By the time the bill is fully implemented in 2014, health-insurance exchanges will be in place throughout the nation to test whether the private insurance industry can satisfy the needs of the public. At that time, no adults with preexisting conditions can be discriminated against by health insurers; women will no longer be subjected to higher premiums than men; the nation will be investing in improving the supply of primary-care doctors and nurses; and community health centers will be receiving additional support.
At the same time, progress will have been made in ensuring that tests and treatments proven to work are being applied to patients. Most important, some 32 million previously uninsured Americans will enjoy the physical and psychological benefits of knowing they have health insurance.
A core principle of the discipline of operations research is that a successful solution has to be at least as complex as the problem. The health-reform law is certainly complex, but so is the so-called U.S. health-care system.
Few pieces of legislation prove to be perfect on enactment, and our world is constantly changing. There will be changes we wish to make as implementation unfolds, and these can be accomplished. The law offers all of us the opportunity to put our shoulders to the wheel to ensure successful implementation and identify areas for improvement.
The current clamor for repeal is a fool's mission. Let's hope such talk dies a natural death as the benefits of the law become more concrete, beginning today.