Top healthcare challenge could be finding long-lasting solutions to system’s ills
Finding long-lasting solutions is our biggest challenge
If all goes according to plan, next summer should be a mighty interesting time in American politics. That’s when, in the heat of the presidential campaign, the nation is likely to learn the fate of the healthcare reform law, at least according to the collective wisdom of the U.S. Supreme Court.
That timing could be off, but the impact of the ruling will be jolting no matter when it comes, given the lightning rod permanently affixed to the Patient Protection and Affordable Care Act. And the decision will be electrifying no matter which way it goes.
As has been reported extensively in the past week, the high court has agreed to take on several legal challenges to the reform law, allocating an extraordinary amount of time for oral arguments next spring for both sides to make their case.
While the justices seem to have an “out” allowing them to punt the decision to 2014 because of the intricacies of one challenge to the law, let’s keep our fingers crossed that the court doesn’t take that route. It will be extremely beneficial all around to have clarification from the top court over whether Congress and the Obama administration overstepped their constitutional authority or if in fact the lawmakers got it right.
With the SCOTUS review now just over the horizon, it’s a worthwhile exercise to remember what led to last year’s passage of the Affordable Care Act, after some 100 years of trial and error on healthcare overhaul legislation.
While the myriad challenges facing healthcare demanded that Washington finally take action, let’s remember two key drivers: access and cost. The Affordable Care Act takes the issue of access head-on, aiming to greatly expand insurance coverage and availability of care. Fixing the problem of cost will prove much trickier, and it’s where legislative refinements are needed.
If the reform law’s mechanisms designed to decrease the number of uninsured by 30 million starting in 2014 fail to be implemented as a side effect of any high court ruling, there’s one simple question: What’s the alternative plan? Haven’t seen one yet that approaches the ACA’S ambitious goals, with the exception of a Medicare-for-all single-payer plan.
There’s no doubt that access to healthcare continues to be inhibited. An October report from the Commonwealth Fund titled Why Not the Best? Results from the National Scorecard on U.S. Health Sys
tem Performance, 2011 points to continued shortcomings in the U.S. health system’s ability to deliver affordable, accessible and efficient care. The report, based mainly on 2007-09 data, noted a drop in scores compared with similar analyses in the past two years.
“Of great concern, access to healthcare significantly eroded since 2006. As of 2010, more than 81 million working-age adults—44% of those ages 19 to 64—were uninsured during the year or underinsured, up from 61 million (35%) in 2003,” according to a summary of the report. “Further, the U.S. failed to keep pace with gains in health outcomes” achieved by other leading nations, the summary states.
Meanwhile, earlier this month, the Gallup organization noted another decline in its Gallup-healthways Basic Access Index, which uses 13 metrics, including Americans’ ability to afford food, housing and healthcare, to gauge our overall well-being.
For October, the index fell to its lowest point since its inception in 2008, meaning it was weaker than during the worst months of the Great Recession. Healthcare measures that are part of the calculations include health insurance coverage and access to caregivers and medications.
So it’s obvious the U.S. continues to struggle with access to healthcare. What’s even more apparent is that, depending on the high court’s decision, we might have a tougher time gaining access to long-lasting solutions.
DAVID MAY Assistant Managing