A New Era in U.S. Health Care: Critical Next Steps under the Affordable Care Act

A New Era in U.S. Health Care: Critical Next Steps under the Affordable Care Act

A New Era in U.S. Health Care: Critical Next Steps under the Affordable Care Act

A New Era in U.S. Health Care: Critical Next Steps under the Affordable Care Act

Synopsis

A New Era in U.S. Health Care demystifies the Affordable Care Act for unfamiliar readers, setting an agenda for lawmakers and the health industry alike. It focuses on four key issues that will determine the success of this 2010 legislation: the use of state-run Medicaid programs to expand access to insurance; the implementation process; the creation of health insurance exchanges; and the introduction of a new organizational form, accountable care organizations.

Excerpt

In the spring of 2010, I published a book about the U.S. health care system. It described how the system works and the problems that result from its operation. I made the case that those problems needed to be solved because they threatened the system’s future and were undermining the ability of Americans to get good care when they needed it—even when they had health insurance.

Moreover, I argued, the solution required that the federal government take a large role because the national system as a whole needed to change—and more quickly than if we relied on the normal evolutionary process built by the accumulation of individual actions. The main reason for both reform and a large federal role in it was that existing system dynamics were leading inevitably to further system deterioration even though each individual and each group were making decisions they thought were best for them.

The book also demonstrated that the origin of the problems lay primarily in dysfunctional incentives faced by all parties to the system—employers, insurers, individuals and families, providers of services, and even federal and state governments. All were making choices they thought were rational for themselves, at least in the short run, but when added together, those choices created problems . . .

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