However, the ACA falls far short of what the rest of the industrialized world offers its citizens for health care coverage. And the ACA does nothing to protect people from medical bankruptcy: what if I can't afford to pay the out-of-pocket expenses I incur? I could still be sued in bankruptcy court. How insane is that? I remember telling someone about the "good news" we had from the preliminary rates posted on MNsure--that my husband would save close to $200/month in premiums for a "bronze" plan. He just sighed. He is from Australia and said to me, "Joanne, I don't pay $200 month for total coverage."
An in-depth recent piece in New York magazine takes the reader through the journey of the ACA, the Republican push to kill it, and the United States' inability to move off its for-profit health care delivery system that lacks behind the rest of the world in terms of cost and accessibility. The article does, however, acknowledge the ACA as the first step needed for long-term reform:
"And health experts increasingly expect the reforms will bear fruit. "The ongoing slowdown in the health-care growth rate defies historical post-recession patterns and is likely to be -sustained," concluded PricewaterhouseCoopers in June. "It appears that the reforms will stick and health-care exchanges and other policies will bring competitive pressure to markets," says Randall Ellis, a professor of health-care economics. "Although the proof for this point of view is not yet definitive," reports the Health Affairs blog, "the depth and breadth of change suggest that significant transformation in the nation's delivery system is under way." Among healthcare wonks, this is no longer a controversial assertion: The evidence thus far suggests Obamacare's cost reforms are a staggering success."
If the ACA helps move us to the sanity of a single-payer system, then all of this is worth it. Access and affordability--key components of the ACA--are important features of any healthcare system. But as long as we continue to treat healthcare as an Olympic sport, where some lives are only worth a "bronze" medal, then we will continue to lag behind the rest of the industrialized world that long ago recognized healthcare as a human right.
As Donna Smith, Executive Director of Healthcare for All Colorado, said in a recent column:
"Our health care system is unjust, that much I think I have established over and over again. Our health care system wastes our health care dollars on some of the most inefficient and costly ways of providing care and keeps people from seeking care when it would be the most sensible and affordable. Our health care system is simply a reflection of our societal values. Our health care system values money over life, and values arrogance over compassion."
If the ACA becomes the birth of a new way to deliver healthcare in this country, then it will be a success well beyond premiums and out-of-pocket expenses that I incur in 2014.
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