- Healthcare a luxury… in the United States??!! Yes. To a small portion of the population (e.g. unionized workers, CEOs) this is a reality. Whether it is the lack of co-pays or deductibles that encourage overuse of medical care, it is believed that these plans drive up the costs of other plans for the general public and deserve the “Cadillac Tax.”
- More emphasis placed on shared responsibility (copayments) on the part of families receiving assistance through programs like CHIP have shown a quantifiable reduction in utilization of health care services.
- Underscoring the inefficiencies of the federal government, a recent study highlighted wasteful spending for patients who received care under the Veteran’s Affairs system.
- Fee-for-service payments met their match. Payment bundles may improve efficiency and reduce costs for surgical procedures in both the public and private sectors.
- Premium support for Medicare may be provide more predictable cost savings for the government overtime, but would be more costly and may require major plan changes for seniors.
- As the popularity of smoking continues to wane, the CBO proposes an addition to the excise tax that not only would further decrease smoking but also may help reduce the federal deficit.
Looking Ahead
The year 2012 will go down in history if not for the Supreme Court ruling to uphold the constitutionality of the ACA, then for the decision of the American people to extend the leadership of the ACA’s biggest supporter.
With health care as a major recurring theme in the 2012 election, the American people sent a clear message with the re-election of President Obama. Access to affordable, quality health care matters!
Whereas the free market has failed to achieve this goal, the Affordable Care Act has opened a window of opportunity for quality and access for millions of Americans. Now as one of the last developed countries to move towards a national healthcare system, the United States continues to grapple with the ideals that drive access and quality.
The major unfinished business likely to roll over into 2013 are (1) state refusals to expand Medicaid and set up insurance exchanges, (2) the true impact of the ACA on healthcare costs and physician pay, (3) growing opportunities with unconventional healthcare delivery methods, and (4) the use of policy to modify human behavior to promote health and safety.
Stay tuned; 2013 is going to be an interesting year!
by Nii Darko, DO, MBA and Renée Volny, DO, MBA









