An inaccessible, incomprehensible application website. Health plan options that don’t seem to meet the big “A” in “ACA” (affordability) by most Americans’ definitions. Longstanding health policies being dropped by insurers, purportedly because plans fail to meet ACA coverage requirements. Shifting schedules for implementation, and vague and ever-changing regulations. Mass confusion. Take your pick, or choose them all; it seems that everyone has at least one legitimate bone to pick with “Obamacare.”
What seems to have been lost in the current acrimonious debate is why President Obama chose to go down the “health reform” path in the first place. So, as we enter a new year, let’s recap: the U.S. healthcare system is mess, and was a mess long before Barack Obama first set his sights on the White House. Democrats and Republicans all share in the blame for producing and perpetuating a system that overcharges, overtreats some and undertreats others, rewards poor quality, ignores safety, and fails to deliver on any of the Institute of Medicine’s six essential properties: Effectiveness, Efficiency, Timeliness, Patient-Centeredness, Equitability, and Safety.
I understand the outrage over the ACA implementation disaster. But, where is the outrage over 400,000 Americans dying every year in hospitals due to infections and other preventable complications of care, or spending twice as much as every other industrialized nation on health care, on a per capita basis, with nothing to show in terms of care access, quality, and health outcomes?
Most importantly, given the ACA’s core mission of extending health insurance to the previously uninsured, where is the outrage over 40 million Americans not having health insurance? The United States, despite its wealth, and significant investment in healthcare, representing 18% of the economy, is the only industrial nation that has not had some form of health coverage for all of its citizens. In my view, that’s more outrageous than any of the potholes we’ve encountered on the road to expanding coverage.