MOVING HEALTH CARE FORWARD: A panel convenes Dec. 20 at the Center For American Progress to discuss implementing the health care reform act. From left to right: Steven Lieberman, Lieberman Consulting, Inc.; Glenn Hackbarth, chairman, Medicare Payment Advisory Commission; Judy Feder, senior fellow, Center for American Progress; Debra Ness, Leader, Campaign for Better Care; and Jonathan Blum, deputy administrator and director, Centers for Medicare and Medicaid Services. (Gary Feuerberg/The Epoch Times)

Health Care Reform Act Progressing Despite Challenges

By Gary Feuerberg

December 27, 2010 Updated: December 27, 2010

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WASHINGTON—Despite Republican opposition and court challenges, the Affordable Care Act (ACA), better known as the health care reform act, is marching forward. Discussions on how best to implement ACA are now underway with the potential to fundamentally alter the way medicine is practiced and paid for in the United States.

When President Obama signed into law in March the ACA, only the broad outline features for its implementation were provided. The aim was clear, however. The consensus of the providers of care agrees that the ACA must stop the growth of medical costs and improve care results.

“We know medical care can be better organized and delivered,” said Judy Feder, senior fellow, at the Center for American Progress. “Every analyst who studies health care believes it is possible to simultaneously lower costs and improve quality. The major question is how to realize it,” she writes in a paper with coauthor David M. Cutler, senior fellow at the Center for American Progress and professor of Applied Economics at Harvard University.

Feder, professor of public policy at the Georgetown Public Policy Institute, was the moderator of a panel discussion, Dec. 20, at the Center for American Progress—a Washington progressive think tank—composed of specialists who are floating various ideas around to solve our health care crisis.

Nancy-Ann DeParle made some introductory remarks before the panel began. She is President Obama’s point person for overseeing the ACA.

“Our health care system doesn’t reward doctors and hospitals today to keep patients healthy. In fact, it does just the opposite. We pay more for more care, regardless of the outcome, and that doesn’t make sense,” said DeParle, director of the White House Office of Health Reform and counselor to the president.

Laying Ground Rules for Insurance Companies

DEFINING THE ACOs: The Affordable Care Act designates accountable care organizations (ACOs) as the way in which medical care in the United States will be organized. Jonathan Blum, deputy administrator and director, Centers for Medicare and Medicaid Services, will cull the recommendations and comments concerning ACO definition. (Gary Feuerberg/The Epoch Times)

DeParle said that during the nine months since the president signed the ACA, the work in implementing it has laid ground in setting up “new rules of the road” for the insurance companies and gives consumers more transparency over what happens in the health insurance market.

Many of what she called the “patient’s bill of rights” involve consumers’ relations with their insurance company. Under the ACA, “patients that require services in an emergency room of a hospital that is not in their plan’s network will still be covered without prior approval,” she said.

“Insurance companies won’t be able to discriminate against children because of a pre-existing condition,” she said. “Consumers will be able to appeal a decision made by their insurance company to an independent third party.”

DeParle said that under the new insurance plans, Americans would get preventive services without additional out-of-pocket expenses.

DeParle warned of a dire outcome if the ACA was repealed. For one, the 32 million Americans who are gaining coverage will remain uninsured. Insurance companies would be free once again “to impose double digit premium rate increases that Americans have been seeing through the past decades without any real oversight, transparency, or accountability,” she said.

And all the protections in the new Patient’s Bill of Rights would “evaporate,” she added.

ACOs

ADVICE: Steven Lieberman (L), visiting scholar, Brookings Institution, and Glenn Hackbarth, chairman, Medicare Advisory Commission, offer advice Dec. 20 at the Center for American Progress on how to structure the new ACOs. (Gary Feuerberg/The Epoch Times)

DeParle said the next phase in implementing ACA is reforming the delivery system to make health care work better for patients and over the long run lower costs. Changes in this area require hospitals, employers, doctors, nurse, consumers, and others to coordinate in new ways.

The vehicle for achieving efficiencies in cost and improvement in care of the ACA will chiefly lie in what the health care law designates as “accountable care organizations” (ACOs). The ACOs will bring physicians together to “gain efficiencies and improve quality” and experiment with various ways to bring down costs.

The federal agency that oversees Medicare, the Centers for Medicare and Medicaid Services (CMS), has the task of defining the rules by which the ACOs are set up. Medicare programs will be the first ACOs to experiment with new methods of care and payment.