The health care reforms passed by the ACA (the Patient Protection and Affordable Care Act, or Obamacare) extended health insurance to millions of Americans who previously had no coverage. They also introduced new policies to control costs, improve quality of care and system performance, and expand public health initiatives.
But more work is needed to bring a basic level of high-quality healthcare within reach for most Americans. Many are still struggling to pay physician visits and prescription drug prices, cover deductibles, or navigate a confusing, frustrating health insurance system. Still others worry about a future without the health care reforms they’ve come to depend on.
While the ACA brought significant improvements, more progress is needed. A major objective must be to bring about a fundamental change in the attitudes of people about healthcare costs, coverage, and quality. This includes reducing the perception that government is out of control and promoting a view that people should be able to manage their own health care needs with a reasonable amount of financial help.
Another key goal must be to bring about a fundamental shift in the behavior of individuals, professionals, and the overall health care system. For example, current incentive systems encourage expensive medical interventions and prescribe medications that carry risks for patients. But they do not encourage other activities that are much more effective, including modifying one’s lifestyle and adherence to prescribed regimes. Similarly, perversely, the current fee-for-service system rewards hospitals for high readmission rates, even though they are bad for patients.