The Beginning of Health Reform

On March 23, 2010, President Obama made history by signing into law the Patient Protection and Affordable Care Act, a landmark statute that aims to fundamentally reform virtually all aspects of the nation’s health care system. The health reform law is fairly viewed as the most sweeping social policy legislation since Lyndon Johnson’s Great Society initiatives.

There are many specific goals of the statute, including expanding health insurance coverage, increasing access to health care services, improving health care quality, enhancing the value of care received, eliminating racial and ethnic health disparities, strengthening the public health infrastructure, expanding and diversifying the health care workforce, and encouraging consumer and patient wellness at home and at work. More fundamentally, however, the goal of health reform is to restructure the current health care system into one that operates more fairly, more efficiently, and with more accountability on the part of the many different stakeholders involved.

Although passage of the law was 14 months in the making, the statute itself is merely the first step. Next comes the truly challenging part: translating the enormous (and enormously complex) law into a transformed health system.  This process will take many years, many regulations (some estimates peg the number of pages of regulations needed at 15,000), and many bouts of judicial interpretation. In fact, the law is already on Justice Stephen Breyer’s radar. While testifying recently before a subcommittee panel of the House Appropriations Committee in support of the Supreme Court’s annual budget request, he was asked why the number of cases on the Court’s docket continued to slide. Somewhat deflecting the question, Justice Breyer told the subcommittee that the Court’s docket tends to spike in the years following passage of a major piece of federal legislation, and he cited specifically to the 2,409-page health reform law as one which will undoubtedly increase the Court’s case load.

Yet, because of the technical, political, and economic challenges sure to arise throughout the law’s implementation, court decisions and administrative regulations alone won’t do the trick. Nor will structural change of the system itself, as contemplated by the statute, be enough. In order for health reform to be successful, the philosophies and behaviors of all involved must change. Individuals, employers, government health officials, insurers, and health care professionals, institutions, and suppliers alike will be expected (and in many cases, required) to fundamentally alter their behaviors, expectations, and business practices. Indeed, particularly as the inevitable pushback against some of the law’s more controversial elements begins, the country must adopt a holistic vision of the purpose of health reform if the fundamental improvements to health and health care initiated by the reform law are to be woven into the fabric of American society.

This Post Has One Comment

  1. Nick Zales

    The only “sweeping” this legislative abomination will do is sweep more money from taxpayers’ pockets into the hands of the health-care industry. Americans will continue paying the highest health care costs in the world while the general population receives the least health care.

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