I feel that ACA is generally positive in that it is an attempt to insure more who could not otherwise afford healthcare plus attempt to digitize patient data. I could complain (and often do) about the Meaningful Use process and suspect the elusive 'interoperability' will continue. It has also kept me employed so I've got that going for me which is nice
NoHorseInThisRace - 8 years ago
It's a step in the right direction. Any regulatory change to a marketplace is going to have winners and losers. We have the same problem post-ACA that we did pre-ACA; namely that people make poor health choices in this country. More people are insured (yay!) but care still isn't affordable (boo) and trying to modify the way insurance markets work isn't likely to change that.
Mary C - 8 years ago
The legislation (as do most things in life) had good and bad qualities. Are more people insured....sure. Affordable- no where near. But my biggest issue is when I hear a politician talk about "how we reformed healthcare." We have not touched the delivery of care......we had insurance reform so let's call it what it is rather than try and paint a beautiful picture. To reform healthcare, we are going to have to look at how many regulatory bodies have their "hands" in the pie and determine which of those regulations actually improve patient care. Eliminate the rest. Then take a look at eliminating waste..........real waste not just randomly cutting positions. I fail to believe our government is capable of performing either of those tasks.
Let's take a step back here and look at some of the main popular provisions of the ACA: Insurance companies can't refuse to cover pre-existing conditions (death panels), lifetime limits are gone, many preventive care service are covered without copays, mental health provisions, ability to stay on parents plan till age 26, companies have to pay at least 80% of funds for claims. In return, most people were forced into the arms of the insurance companies to hopefully spread out risk and cost. Sounds simple enough. The problem was that without better cost controls, insurance companies responded with high-deductible plans and other tricks to cover themselves. I think the Administration unwisely overestimated the "kindness" of the insurance carriers. Add to this an uneven marketplace in the states (NC for example is controlled mostly by one carrier). So, yeah there are still problems, but there are lots of people whose lives were literally saved by the ACE, like my friend's son from TX with CF.
HIT Project Manager - 8 years ago
"Affordable" - Misnamed because in almost every instance besides those who weren't insured in the first place, costs have gone up. Many employers choose to stop providing coverage and allow their employees to get care from the "affordable marketplace" only to have their employees find the care they are getting there costing more for them while reducing the choices they had under their employers plans. How can we call any of that "affordable"?
"Care" - You can't offer care to more people for the same amount of money without marginalizing the quality or effectiveness of care provided to a fewer number of people. Think about going from buying your fitted clothes from a tailor to a Walmart and ask yourself do you think you will be happy with the result? The 'care' that ACA subsidizes is ineffective in that it only makes society more dependent on late interventions in chronic disease interventions using costly procedures and/or medications that only marginally offsetting the length of the patient's life while often if not always to some degree diminishing the quality of it. How can anyone call that "care" they would want affordable or not? The only care that will ever make sense for the government to subsidize 100% of is preventative/proactive care such as regular doctor check-ups from childhood on, dental exams/care, pre-natal care and other clinic based care that seeks to identify and correct preventable problems long before they require acute care. All care for preventable problems (e.g. obesity, type 2 diabetes, early on-set heart disease/cancer directly attributable to poor choices such as smoking, poor dietary habits should not be paid by insurance/Medicaid but instead be out of pocket expenses paid by the person receiving the care. Such decisions can be made easily as a function of validated well documented clinical records that demonstrated the recipient ignored the recommendation of the 'free' primary/preventative care they received that was 100% subsidized. Such a proposed method could be 'grandfathered' and 'gradually' implemented as a function of when the subsidized preventative care began for the recipient so that 20-30 years from now, subsidized interventions for preventable disease for such people will be completely eliminated.
'Act' - that government has to 'act' to respond to the neglect what caregivers have implored for us to do already (eat healthy and exercise) for long before we had modern medicine, says that the government isn't solving the problem, the government IS the problem. Any 'act' short of holding the public accountable for their own health from the early onset of preventable diseases is grossly irresponsible. The electorate needs to be educated to vote out of office any representative who thinks they are doing a better job of caring for their constituents than their caregivers or the people themselves.
Festus - 8 years ago
Any government program born from a lie (“If you like your doctor, you can keep your doctor”, “If you like your insurance plan, you can keep your insurance plan”) is doomed to fail. ACA has been a substantial contributor to limited networks, high premiums, and high deductibles and is unsustainable in its present form (like most government programs). Some will argue that “some people have benefited” – very true. But some people benefited from WWII, which cannot be viewed as other than a world-wide disaster.
Bill Spooner - 8 years ago
ACA has increased the population covered by insurance by adding to the federal deficit, with scant evidence of improving either quality or cost.
Stephen Gould - 8 years ago
Like most Acts of our Congress, the name says everything it isn't. People of course need access to health care; was this the best way to increase the access of those without insurance? Those that had affordable coverage before the now do not, so it appears to be an 'everybody loses' situation.
I am afraid the only way to really improve the situation is to have a single payer system, which unfortunately would mean having our famously ineffective Federal Government involved in a meaningful way.
Medicare and Medicaid could be morphed into what we really need, which is good care when we are injured or ill, and preventative care to help keep us healthy in the first place.
While there are real positives and negatives to the ACA, I tend to see the positives as outweighing the negatives. At the most basic level, providing a modicum of insurance for tens of millions of people who were previously uninsured is a huge win for our country. Even with the high-deducible insurance plans that are out there, the ACA should put a significant dent in personal bankruptcies, most of which stem from unanticipated huge medical expenses. I also appreciate the move toward quality and interoperability that are built into the ACA.
There are negatives, as well, in my mind. The exchange plans are not great and, due to their high deductibles, are making patients reconsider whether they should engage a physician when they need on, thereby pushing more patients to seek care in emergency settings once their symptoms become impossible to ignore. Also, although the ACA has been at least partially responsible for the slowing growth in healthcare costs, the unpredictability of the insurance markets is starting to manifest itself in more dramatically higher premiums (in addition to the higher out-of-pocket costs in many health plans now).
On balance, I would say, the ACA is a real net positive, but we are well-served to not ignore those areas that are major opportunities for improvement.
It's a mess. Insurance coops failing, People having to pay double deductibles, HITech wasted $30bill and original ROI estimate of $800bill has been retracted by the Rand Corp.
Glen Marshall - 8 years ago
The ACA is another small step forward in a long slow journey, begun with the implementation of Medicare and Medicaid in the 1960s.
I feel that ACA is generally positive in that it is an attempt to insure more who could not otherwise afford healthcare plus attempt to digitize patient data. I could complain (and often do) about the Meaningful Use process and suspect the elusive 'interoperability' will continue. It has also kept me employed so I've got that going for me which is nice
It's a step in the right direction. Any regulatory change to a marketplace is going to have winners and losers. We have the same problem post-ACA that we did pre-ACA; namely that people make poor health choices in this country. More people are insured (yay!) but care still isn't affordable (boo) and trying to modify the way insurance markets work isn't likely to change that.
The legislation (as do most things in life) had good and bad qualities. Are more people insured....sure. Affordable- no where near. But my biggest issue is when I hear a politician talk about "how we reformed healthcare." We have not touched the delivery of care......we had insurance reform so let's call it what it is rather than try and paint a beautiful picture. To reform healthcare, we are going to have to look at how many regulatory bodies have their "hands" in the pie and determine which of those regulations actually improve patient care. Eliminate the rest. Then take a look at eliminating waste..........real waste not just randomly cutting positions. I fail to believe our government is capable of performing either of those tasks.
Let's take a step back here and look at some of the main popular provisions of the ACA: Insurance companies can't refuse to cover pre-existing conditions (death panels), lifetime limits are gone, many preventive care service are covered without copays, mental health provisions, ability to stay on parents plan till age 26, companies have to pay at least 80% of funds for claims. In return, most people were forced into the arms of the insurance companies to hopefully spread out risk and cost. Sounds simple enough. The problem was that without better cost controls, insurance companies responded with high-deductible plans and other tricks to cover themselves. I think the Administration unwisely overestimated the "kindness" of the insurance carriers. Add to this an uneven marketplace in the states (NC for example is controlled mostly by one carrier). So, yeah there are still problems, but there are lots of people whose lives were literally saved by the ACE, like my friend's son from TX with CF.
"Affordable" - Misnamed because in almost every instance besides those who weren't insured in the first place, costs have gone up. Many employers choose to stop providing coverage and allow their employees to get care from the "affordable marketplace" only to have their employees find the care they are getting there costing more for them while reducing the choices they had under their employers plans. How can we call any of that "affordable"?
"Care" - You can't offer care to more people for the same amount of money without marginalizing the quality or effectiveness of care provided to a fewer number of people. Think about going from buying your fitted clothes from a tailor to a Walmart and ask yourself do you think you will be happy with the result? The 'care' that ACA subsidizes is ineffective in that it only makes society more dependent on late interventions in chronic disease interventions using costly procedures and/or medications that only marginally offsetting the length of the patient's life while often if not always to some degree diminishing the quality of it. How can anyone call that "care" they would want affordable or not? The only care that will ever make sense for the government to subsidize 100% of is preventative/proactive care such as regular doctor check-ups from childhood on, dental exams/care, pre-natal care and other clinic based care that seeks to identify and correct preventable problems long before they require acute care. All care for preventable problems (e.g. obesity, type 2 diabetes, early on-set heart disease/cancer directly attributable to poor choices such as smoking, poor dietary habits should not be paid by insurance/Medicaid but instead be out of pocket expenses paid by the person receiving the care. Such decisions can be made easily as a function of validated well documented clinical records that demonstrated the recipient ignored the recommendation of the 'free' primary/preventative care they received that was 100% subsidized. Such a proposed method could be 'grandfathered' and 'gradually' implemented as a function of when the subsidized preventative care began for the recipient so that 20-30 years from now, subsidized interventions for preventable disease for such people will be completely eliminated.
'Act' - that government has to 'act' to respond to the neglect what caregivers have implored for us to do already (eat healthy and exercise) for long before we had modern medicine, says that the government isn't solving the problem, the government IS the problem. Any 'act' short of holding the public accountable for their own health from the early onset of preventable diseases is grossly irresponsible. The electorate needs to be educated to vote out of office any representative who thinks they are doing a better job of caring for their constituents than their caregivers or the people themselves.
Any government program born from a lie (“If you like your doctor, you can keep your doctor”, “If you like your insurance plan, you can keep your insurance plan”) is doomed to fail. ACA has been a substantial contributor to limited networks, high premiums, and high deductibles and is unsustainable in its present form (like most government programs). Some will argue that “some people have benefited” – very true. But some people benefited from WWII, which cannot be viewed as other than a world-wide disaster.
ACA has increased the population covered by insurance by adding to the federal deficit, with scant evidence of improving either quality or cost.
Like most Acts of our Congress, the name says everything it isn't. People of course need access to health care; was this the best way to increase the access of those without insurance? Those that had affordable coverage before the now do not, so it appears to be an 'everybody loses' situation.
I am afraid the only way to really improve the situation is to have a single payer system, which unfortunately would mean having our famously ineffective Federal Government involved in a meaningful way.
Medicare and Medicaid could be morphed into what we really need, which is good care when we are injured or ill, and preventative care to help keep us healthy in the first place.
While there are real positives and negatives to the ACA, I tend to see the positives as outweighing the negatives. At the most basic level, providing a modicum of insurance for tens of millions of people who were previously uninsured is a huge win for our country. Even with the high-deducible insurance plans that are out there, the ACA should put a significant dent in personal bankruptcies, most of which stem from unanticipated huge medical expenses. I also appreciate the move toward quality and interoperability that are built into the ACA.
There are negatives, as well, in my mind. The exchange plans are not great and, due to their high deductibles, are making patients reconsider whether they should engage a physician when they need on, thereby pushing more patients to seek care in emergency settings once their symptoms become impossible to ignore. Also, although the ACA has been at least partially responsible for the slowing growth in healthcare costs, the unpredictability of the insurance markets is starting to manifest itself in more dramatically higher premiums (in addition to the higher out-of-pocket costs in many health plans now).
On balance, I would say, the ACA is a real net positive, but we are well-served to not ignore those areas that are major opportunities for improvement.
It's a mess. Insurance coops failing, People having to pay double deductibles, HITech wasted $30bill and original ROI estimate of $800bill has been retracted by the Rand Corp.
The ACA is another small step forward in a long slow journey, begun with the implementation of Medicare and Medicaid in the 1960s.