The author of this article presents his arguments as if he is saying something new, but I think anyone who has been at least somewhat objectively following the formation and implementation of the Affordable Care Act would concede that its strengths are not in cost-containment. There are a plethora of provisions and changes contained within the legislation, but the most significant of these are aimed at improving access and protecting consumers. Goodman seems to be troubled by the lack of media coverage and analysis of these cost-cutting provisions which are present in the act (although he does seemed to be impressed by his own attention to this topic), but I would argue that this coverage is actually proportional to the impact this law will likely have on costs.
The most troubling aspect of Goodman’s arguments is that he seems to lose sight of the incremental nature of health care reform, or any national reform for that matter, within our country’s political system. After all, we waited until the 60’s to create Medicare and Medicaid, and just to be sure we didn’t rush into anything, we waited over 30 years before passing another major piece of health care legislature. During the in-between, there were innumerable small scale changes and tweaks to our system, and I would be willing to bet the same will be true in the aftermath of the passing of the ACA.
Obviously the cost of health care has been and continues to be a major issue facing our country, but the fact that the ACA does not solve all of our nation’s problems should not prevent us from appreciating what it does (or should) accomplish. Health care consumers now have much greater protection from the whims of insurance providers, and millions of people who were previously uninsured and without any predictable access to the health care system, now have a means to receive quality medical care. And by now, I mean in 2014.
Clearly, the ACA is not perfect, but no piece of legislature is. But perhaps some of the proposed cost savings will produce modest reductions in spending over time as the CBO has estimated. And perhaps we will be able to build on these savings at a slow, steady pace, continuing our long standing tradition of incremental health care reform.
Actually, I found this article quite meaningful in integrating what we have learnt in Microeconomics, Health Service Research and US Health System. Science is skepticism by its nature, so is politics. If the value that each of us has the right to keep well-being still dominates in our society, I would argue that PPACP deserves this chance of reform and the $938 billion in the next decade to achieve this goal.
I agree Goodman's view that price of service will continue to go up if there will be no more supply to meet with the assuming increasing demand, which is basically true in the world of free market. But just as Brian mentioned in last discussion, there might be no market or just quasi-market here in the field of health care. Healthcare service differentiates itself to the other types of services in terms of its nature of dealing with life and death, and the lack in elasticity of price, which means the quality of demand and supply will not necessarily coordinate with the change in price. It is the realm where government and population themselves can play a more important role in the regulation of behaviors and cost.
It seems that the balance between the efforts in making healthcare universal and controlling cost will call for continuous examination. But the management of expenditure should never be implemented by scarifying people’s right to getting access to the health care service in need. Reducing waste, avoiding defensive practice and induced demand always function as good alternatives in curbing continuously increasing cost. Admittedly, modifying either consumers or providers behaviors can be much difficult and even costly. But in the long term, it helps to shape desirable atmosphere of provision and consumption of healthcare service, where the nature of certain welfare should never disappear. I agree with Goodman that the new health reform plan will contribute little to control cost through regulating the process of payment. Providers are more powerful in asking for good price for their services in the age of aging and advanced modern technologies. But we can still make efforts in modifying utilization without getting people out of the essential health plans. I am wondering that whether we can achieve this goal by exploring and employing more cost-effective practices such as preventive medicine and primary care services, and hence to prevent people from catastrophic diseases that often require huge amount of costly services. Besides, more efforts should be also made in carefully exam the effectiveness and necessity of highly cost medical techniques. If we can slow down or even avoid the progress of disease by practicing services less relied on sophisticated and expensive services, why not investing more on them?
Though the health reform process will be incremental, it is good to see that government is ready to taking the responsibility of making every effort to ensure that people will be able to receive health care to move forward in their journey.
The author of this article presents his arguments as if he is saying something new, but I think anyone who has been at least somewhat objectively following the formation and implementation of the Affordable Care Act would concede that its strengths are not in cost-containment. There are a plethora of provisions and changes contained within the legislation, but the most significant of these are aimed at improving access and protecting consumers. Goodman seems to be troubled by the lack of media coverage and analysis of these cost-cutting provisions which are present in the act (although he does seemed to be impressed by his own attention to this topic), but I would argue that this coverage is actually proportional to the impact this law will likely have on costs.
ReplyDeleteThe most troubling aspect of Goodman’s arguments is that he seems to lose sight of the incremental nature of health care reform, or any national reform for that matter, within our country’s political system. After all, we waited until the 60’s to create Medicare and Medicaid, and just to be sure we didn’t rush into anything, we waited over 30 years before passing another major piece of health care legislature. During the in-between, there were innumerable small scale changes and tweaks to our system, and I would be willing to bet the same will be true in the aftermath of the passing of the ACA.
Obviously the cost of health care has been and continues to be a major issue facing our country, but the fact that the ACA does not solve all of our nation’s problems should not prevent us from appreciating what it does (or should) accomplish. Health care consumers now have much greater protection from the whims of insurance providers, and millions of people who were previously uninsured and without any predictable access to the health care system, now have a means to receive quality medical care. And by now, I mean in 2014.
Clearly, the ACA is not perfect, but no piece of legislature is. But perhaps some of the proposed cost savings will produce modest reductions in spending over time as the CBO has estimated. And perhaps we will be able to build on these savings at a slow, steady pace, continuing our long standing tradition of incremental health care reform.
Actually, I found this article quite meaningful in integrating what we have learnt in Microeconomics, Health Service Research and US Health System. Science is skepticism by its nature, so is politics. If the value that each of us has the right to keep well-being still dominates in our society, I would argue that PPACP deserves this chance of reform and the $938 billion in the next decade to achieve this goal.
ReplyDeleteI agree Goodman's view that price of service will continue to go up if there will be no more supply to meet with the assuming increasing demand, which is basically true in the world of free market. But just as Brian mentioned in last discussion, there might be no market or just quasi-market here in the field of health care. Healthcare service differentiates itself to the other types of services in terms of its nature of dealing with life and death, and the lack in elasticity of price, which means the quality of demand and supply will not necessarily coordinate with the change in price. It is the realm where government and population themselves can play a more important role in the regulation of behaviors and cost.
It seems that the balance between the efforts in making healthcare universal and controlling cost will call for continuous examination. But the management of expenditure should never be implemented by scarifying people’s right to getting access to the health care service in need. Reducing waste, avoiding defensive practice and induced demand always function as good alternatives in curbing continuously increasing cost. Admittedly, modifying either consumers or providers behaviors can be much difficult and even costly. But in the long term, it helps to shape desirable atmosphere of provision and consumption of healthcare service, where the nature of certain welfare should never disappear. I agree with Goodman that the new health reform plan will contribute little to control cost through regulating the process of payment. Providers are more powerful in asking for good price for their services in the age of aging and advanced modern technologies. But we can still make efforts in modifying utilization without getting people out of the essential health plans. I am wondering that whether we can achieve this goal by exploring and employing more cost-effective practices such as preventive medicine and primary care services, and hence to prevent people from catastrophic diseases that often require huge amount of costly services. Besides, more efforts should be also made in carefully exam the effectiveness and necessity of highly cost medical techniques. If we can slow down or even avoid the progress of disease by practicing services less relied on sophisticated and expensive services, why not investing more on them?
Though the health reform process will be incremental, it is good to see that government is ready to taking the responsibility of making every effort to ensure that people will be able to receive health care to move forward in their journey.