Passage of reform this year was a breakthrough against a wall of resistance that has prevented progress in reforming health care for decades. Tens of millions of Americans who had no health insurance, at all, will gain coverage under this law. Millions will have better coverage than before.
But the job is incomplete.
The federal insurance reform contains some building blocks for containing cost growth, but the new law does not stack them together in a coherent strategy to prevent health cost hyperinflation that continues to undermine the financial wellbeing of working families and their employers.
I was heartened to hear Rep. James Clyburn’s view, when, as a guest at America’s Agenda’s most recent Board meeting, he opined that the federal health insurance reform of 2010, like the Civil Rights Act of 1964, is only the beginning of a process of reform – a foundation to be built on with follow-up legislation.
The health cost crisis facing America’s working families and businesses will not be overcome unless Congressman Clyburn’s prediction comes true.
George Halvorson, President and CEO of Kaiser Permanente, expressed a similar view in a letter he sent to his America’s Agenda Board colleagues following enactment of the federal reform law: “…as important as greater access to health care will be for the American people, costs will continue to grow for workers and their families if we, as a country, don’t take further steps toward improving care and changing payment incentives…We must recognize that the work of reforming our nation’s health care system has just begun.”
Nevertheless, the federal reform law does give states a box of new tools for building high-performance health care systems that can dramatically reduce cost growth as they improve medical outcomes.
If our country is to wrestle the health cost crisis down to manageable size over the next few years, states, public and private health plans, local health care providers and purchasers will all need to seize the opportunities PPACA has created to improve health system performance. We will have to go beyond insurance reform to transforming the way we deliver and consume health care, itself. The PPACA provides some important new tools for doing this – particularly in design of the new state health insurance exchanges.
States can opt not to use their new tools, of course. Some have already done so. But state leaders who opt out of innovative and robust implementation of the PPACA are choosing, quite simply, to forgo the most promising opportunity to drive down costs and improve performance of their local and state health systems that has ever existed.
The PPACA, by itself, doesn’t complete the health system transformation America needs, but it provides the best platform we’ve ever had for taking the next big steps in the right direction.