The end of the 2012 race for the White House opens a new chapter in the movement to bring reform to America’s health care system. Several thoughts come to mind as the health care debate morphs into the reality that the Affordable Care Act, Obamacare, will remain as a permanent part of our social and health care fabric.
For one, there is a certain finality surrounding ACA. It will take its place alongside Medicare and Medicaid as the last major effort of the
federal government to provide health care coverage to a large segment of Americans. Second, a diverse group of businesses, health care providers of all types, state governments and individuals can begin to craft workable approaches to this new reality.
These approaches will include implementation and modification but are not likely to include serious efforts to repeal. Such course setting is extraordinarily important and helpful. Markets react well to certainty. Humans find comfort in what’s familiar and that expectations we know will be maintained.
Long ago I used to officiate basketball. Early in my training I worked a game between two inner city rival schools. In the heyday of run and gun basketball, the speed, grace and power of these exceptional 14-year-old athletes was amazing. The gym was packed to the rafters like a district playoff game. The frenetic pace, the noise and the newness of the experience was almost overwhelming. I missed some easy calls and quickly found myself on the wrong side of both coaches’ temperaments. One coach kept saying, “Just call the game the same on both ends and give us a chance to coach our kids to victory.”
I have never forgotten that comment. He wanted consistency, even certainty, on how the game was being officiated. He had confidence that once the officiating environment was set, he could navigate his team to success.
With certainty comes the ability to plan ahead and make intelligent decisions that are likely, but not necessarily guaranteed, to produce good outcomes. For three years the uncertainty of the election has left hospitals, insurance companies and many others in a collective holding pattern. Uncertainty stifles creativity. Both organizations and individuals loath to embark on a new journey if there remains the nagging fear of wasted effort. Predictability is a bedrock principle.
Two colloquialisms support the certainty principle: “the sun will rise tomorrow” and “the only thing certain is death and taxes.” The former presents a forum for hope in a better day ahead. The later provides the comforting assurance that some things never change, whether we like it or not.
Like the sun rising, there are many good things about ACA. Thirty million more Americans will have some form of health insurance by 2014. Pre-existing conditions and life-time coverage limits that often bankrupt individuals and families are no longer part of the insurance coverage landscape. Preventive screenings for such things as breast cancer and cholesterol testing must be done with no out-of-pocket costs to individuals.
There is more to like, such as incentives for providers to invest in IT solutions like Electronic Health Records and Health Information Exchanges. Both will produce a seamless sharing of patient information leading to more efficient and effective medical treatments. Other incentives encourage migration to medical homes, improvements to consistency and quality of heath care delivery and a focus on better patient outcomes.
As with death and taxes, not all of ACA is so rosy. The biggest uncertainty involves ACA’s cost. President Obama has touted it as the key to reducing government expenditures, mostly through lower utilization and higher quality outcomes. Not only are these promised reductions seriously in doubt, but there is the unsatisfying certainty that ACA brings more taxes, more federal government bureaucracy, unfunded mandates and serious restraints on religious organizations. Imposing unwelcomed taxes is one thing, but infringement on religious liberty is extremely troubling.
In addition, there is the chance of higher insurance premiums for many individuals and the uncertainty of how businesses will react toward maintaining insurance coverage for employees. All of this is coupled with the nagging concern that the private sector is far better equipped to develop and affordably sustain real innovation in health care.
The Affordable Care Act is here to stay. It is now up to politicians of both parties, industry providers and to us as individuals to adapt and embrace the opportunities to reduce costs, improve quality and increase access for all Americans. As the sun rises tomorrow, I have faith in our ability to make it happen.
William F. “Bud” Barrow is president and CEO of Our Lady of Lourdes Regional Medical Center and its entities. Barrow has more than 30 years of experience in health care administration in multiple states. He serves as chairman of the Regional Policy Board of the American Hospital Association and is a board member and past president of the Louisiana Hospital Association.
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US cities bidding on Olympics; Guard prevents more Ferguson riots; storm threatens travel and more national and international news for Wednesday, November 26, 2014.
Wednesday's Blogs from the Bog!
The U.S. rep billed LSU for work allegedly performed on the same days Congress voted on major legislation and held important committee hearings on energy and the ACA.
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Abysmally low participation by the public has prompted the council to scuttle the 2014 survey with plans to simplify it and try again next year.
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Bill Cassidy cast an early ballot Tuesday, seeking to draw renewed attention to a race that has fallen off newspaper front pages and away from people's minds as they plan holiday meals and shopping schedules.
A Lafayette woman faces up to 20 years in prison for running up more than $1 million in unauthorized charges to her company credit card.
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State police say a 47-year-old Lafayette man, who collected more than $83,000 in disability benefits, is accused of operating two businesses out of his home at a time when he claimed he had no income.
Battered all night by Baltimore's relentless pass rush, Drew Brees could feel his protection collapsing and Terrell Suggs getting ahold of him as he urgently unloaded a pass to the right flat toward tight end Jimmy Graham.
After a convincing defeat at the polls on Nov. 4, Earl “Nickey” Picard has decided to let bygones be bygones with his former right-hand man Brian Pope, announcing his support for his former employee’s runoff bid to become Lafayette’s next city marshal.
Saturday the athletic department did everything possible to ensure the 2014 Ragin’ Cajun seniors remembered fondly their last home game. Rain and lightning never arrived but turbulence did in the form of the Appalachian State Mountaineers.
Even stranger than the Republican Party’s decision to hold a “unity rally” earlier this month for Congressman Bill Cassidy in a Baton Rouge bar, Huey’s Bar, was the fact that the establishment was named after Louisiana’s most famous Democrat.
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After failing to pass a medical marijuana bill last year, state Sen. Fred Mills, R-Parks, is telling supporters he will return in 2015 with legislation that focuses on different applications like oils and pills.
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By now, the story of how longtime LSU coach Dale Brown discovered Shaquille O'Neal has been told many times: Brown happened upon a massive 13-year-old at an army base in Germany, stayed in touch with him and eventually became like a second father.
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Facing opposition from a powerful industry, the governor and many in the Legislature, a New Orleans-area flood board's lawsuit against dozens of oil, gas and pipeline companies seemed doomed early on.