The Affordable Care Act (“Obamacare”) is now settled law.
It will be implemented. It will also have to be changed but not until after it is implemented and the required changes becomes obvious and unavoidable. We can all debate what those things will be (cost containment is on top of my list) but it doesn’t matter what we think will happen––time will tell.
There are and will be more lawsuits.
I wouldn’t waste a lot of time worrying about those. Anyone in the market will do better spending their time getting ready.
But, when will the Affordable Care Act (ACA) be implemented?
So far, only about 15 states say they want to implement health insurance exchanges. Some of those may not make the October 1, 2013 kick-off date.
Maybe now that it is clear the law will go forward, some of the conservative states who have said they would not build one will get into high gear rather than have the Obama administration do it for them. But they may not have enough time to be ready in less than eleven months.
The Obama administration says they will be ready on time with federal exchanges. But they have not been at all transparent about just what they have so far done and can get done in the eleven short months that remain.
Starting today, the big question is can the Obama administration really be ready or will the October 1 insurance exchange launch date have to be pushed back, at least in some states?
It’s time for some post-election transparency and honesty from the administration.
Malpractice lawsuits are a necessary evil in our society. At times, they are frivolous, often resulting from a patient’s or family’s anger at a result that was not what they had hoped. Some are actually designed just to try to get a financial settlement. When doctors are sued for malpractice, it is a searing process, isolating and painful. I have known several excellent doctors who have given up established practices so they will never have to go through the possibility of another lawsuit. That is a real loss to society.
But our legal system is also designed to protect patients. Malpractice lawsuits can be justified when a doctor acts negligently or makes a decision that is clearly outside of the bounds of the accepted standard of care.
One of things we know about quality and safety lapses in hospitals, though, is that they are often the result of systemic problems in those organizations. It is not that a doctor or nurse has intentionally committed a clinical error. It is that the way work is organized in the hospital causes errors to occur. For example, many hospital-related infections arise this way, and people die or are harmed as a result. This raises a question as to whether it should be possible to sue for malpractice when a hospital fails to act to correct systemic problems.
Anne Carroll, now retired, has graduate degrees in information science and public health. She raised the question this way recently in a recent health care quality and safety chat room (reprinted here with her permission.)