Not to be overly dramatic, but for me the Supreme Court decision on the Affordable Care Act was a matter of life and death. Because the law was largely upheld, I will be able to continue receiving treatment for breast cancer.
I was one of the early beneficiaries of the law. When I was diagnosed with an aggressive form of breast cancer late last year, I had no health insurance, which meant my options were extremely limited. No insurer would pick up someone in my circumstances. But luckily, the Pre-existing Condition Insurance Plan had already kicked in, and it made it possible for me to purchase insurance under a government program.
I was uninsured not because I’m a lazy, freeloading deadbeat but because my husband and I are self-employed. We had been purchasing health insurance on the individual market along with 6% of the rest of the population. But after exhausting all of our resources trying to keep up with premiums of $1,500 a month, we had no choice but to cancel it.
In the battle over health care that lies ahead, how strongly will the public rally around the need for innovation in confronting health care costs? Does the public view innovation as relevant to the challenge in the first place?
These aren’t idle questions. The news that growth in overall national health care spending has been moderating has raised speculation that innovations in payment and health care delivery are already paying off, notwithstanding the unquestioned impact of the Great Recession.
Looking ahead, uncertainty over the fate of the Affordable Care Act and the likelihood of federal budget cuts yet to come has many fearing that innovations will be vulnerable. And it is not just federal spending that will be at risk. Hospitals and health plans will all be watching their margins carefully to assess how far and how fast they can keep making investments that support innovation (such as investments in healthcare IT, analytics and care coordination) but that may take months or years to generate a return.
All of which places the role of innovation in controlling costs center stage. After all, this is what undergirds the Triple Aim that so many health care leaders have embraced as the only realistic alternative to arbitrary cutbacks in health care services and spending. Health care leaders can defend innovation if they have public support. But do they?
Are the nation’s polltakers part of a surreptitious plot to convince us that what’s good for us is bad and what’s bad is good? A new Harris poll is the third in the space of a week claiming that the public (or some subset of it) is badly misinformed about the Patient Protection and Affordable Care Act. This follows on the heels of similar polls commissioned by Kaiser and the National Council on Aging (which I have criticized at my blog).
Yet the people responding to these polls appear to have a much better understanding than those asking the questions. Consider this tidbit from Harris:
Eighty-two percent think the bill will result in rationing of health care or that it might (it won’t).
Really? Well, what would a reasonable person expect to happen if (a) 32 million newly insured people try to double their consumption of health care, (b) 70 million or so additional people are moved into much more generous insurance than they have today, (c) most of the remaining 200 million people are promised preventive services without the deductibles and copays they face today and (d) almost nothing is done to increase the supply of providers?
Do you think health services are going to magically emerge from thin air? Or is it more reasonable to anticipate significant rationing?
“Just 38% of voters now favor the health care plan proposed by President Obama and congressional Democrats. That’s the lowest level of support measured for the plan in nearly two dozen tracking polls conducted since June.
“The latest Rasmussen Reports national telephone survey finds that 56% now oppose the plan.