obamacare-lessons-for-administrators

From 2010 to 2015, the journey of the ACA has been marred by challenges, resuscitated by results, and motivated by care receivers. The Affordable Care Act has definitely changed the way the nation compares and purchases health insurance. Access of care, healthcare costs, rates of uninsured, Obamacare has made a huge difference. However, considering the mammoth goal set by the administration, the law is still far from what it should be delivering after 5 years of operation. So, what’s going wrong? Here are 6 major lessons for the administration to realize the full potential of the law on the American healthcare system.

  • Give equal weight to corporate and healthcare priorities – While it is impractical to think of a healthcare industry that is driven by only consumer needs and not revenue, a better balance is required between both parties. The administration needs to think of a way to align corporate stakeholders and consumers of healthcare so as to eliminate friction. Since the time the law came into force, corporate lobbyists worked night and day to have a law that was partial to them. Although it was hard for the administration to tread a path that kept everyone happy, some would say that the current healthcare system is still pro-industry. In a deregulated marketplace, it would be hard for the administration to keep a check on rising premium costs every year.
  • A better financing system is needed for better healthcare delivery – In a multi payer system, the avenues for inflating the costs of healthcare are too many, and with a financing system that sides with private health plans, the healthcare delivery quality could become questionable. For instance, before the ACA, the discrimination against people with medical conditions was rampant, but the ACA stopped this practice. Although there are drastic improvements on this front, health plans are continually finding other subtle means to discriminate against unhealthy consumers in risk pools. Through a balanced financing system, the ACA can remove unnecessary channels that leak public money out.
  • A leaf from the book of other developed nations is desperately required – With ACA, the Obama administration introduced several new, untested initiatives into the healthcare system. While some of these systems were fresh and innovative, others had failed in the past. Instead of having trial and run on the American system, the administration can take up case studies of other developed nations on the strategies implemented to stabilize healthcare costs. American healthcare quality to cost ratio is disappointingly bad. Who knows, the administration might unearth a brand new way of saving healthcare costs through testing before implementation.
  • Better risk pools would mean lower costs and better quality – When the ACA was in its nascent stage, the fears of a death spiral were rampant. It was expected that the healthcare law would collapse on itself because it did not have enough young, healthy individuals in the risk pools to sustain the costs of a rapidly changing market. Fortunately, that did not happen, as insurers were able to enroll enough young invincibles to balance their risk pools. However with the King v. Burwell verdict coming out in June, a lot of young individuals might choose to drop their health insurance coverage if their cost sharing subsidies are dropped by the law. In the wake of this damage, the risk pools might get imbalanced once again. The administration needs to work on a lasting strategy that will ensure the involvement of healthy individuals in risk pools for the coming years.

Balancing the healthcare delivery in anti-ACA states – As proven through Medicaid expansion, some states do not fully support of the Affordable Care Act. Several states have cut Medicaid reimbursement, which has ultimately put pressure on doctors, making them hard pressed to accept more Medicaid patients.

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