The Washington Post’s Robert Samuelson castigated President Obama in a recent column for a lack of “judgment” in getting his landmark health-reform law passed. I profoundly disagree.
Obamacare is helping our nation achieve health care that is excellent, accessible to all and affordable. In the 17 months that I led the Centers for Medicare and Medicaid Services, or CMS, I saw how this law is helping tens of millions of families and is finally putting our health care system on the right track.
Samuelson is right to be concerned about health care costs. We’ve been on an unsustainable path for decades. But while he offers no remedy beyond the broken status quo, the president’s reform helps us make health care sustainable the right way: by improving it, not cutting it.
The law does this by targeting the underlying drivers of high health care costs: It supports and rewards caregivers for preventing complications of care, such as health care associated infections, which save both lives and money. The CMS, for example, has set ambitious goals to reduce complications that, if met, would save 60,000 lives and $35 billion in just three years. The law also emphasizes preventive care and cracks down hard on waste and fraud. Last year the government recaptured a record $4 billion. It fosters transparency, so everyone can tell the best performers from the rest. Rather than paying for volume, the law helps us pay for value.
I have seen how improving care can reduce costs dramatically.
The Henry Ford Health System in Detroit has documented savings of $10 million per year from its efforts to improve patient safety. The “Nuka” system of team-based primary care in Anchorage has reduced hospital days more than 50 percent.
Denver Health, using modern, “lean production” approaches to decreasing waste in health care processes, has reduced costs by more than $150 million and achieved the lowest mortality rates among 115 comparable academic medical centers. The Affordable Care Act will help make these successful examples the norm.
The law also stops insurance companies from taking advantage of consumers. It prevents insurers from putting lifetime caps on coverage.
Before Obamacare, 105 million people had one of these caps buried in their insurance contracts — every year, 20,000 unlucky Americans got letters from their insurers saying their coverage was running out. It didn’t matter if they were in their second round of chemotherapy or waiting for surgery; the insurance companies simply said no. Because Obamacare lifted those caps, families have better care and peace of mind.
Obamacare has allowed millions of young people to stay on their parents’ plans until age 26, and it requires insurance companies to cover the preventive care needed to stay healthy. It gives consumers the right to appeal an insurer’s decision and stops insurers from denying coverage to children with pre-existing conditions.
Obamacare also makes it easier and more affordable for businesses to provide their employees with coverage.
The Congressional Budget Office estimates that when the law is fully implemented, it will lower employers’ premiums by making the insurance market more rational and reducing the “hidden tax” we’re all paying for the health care bills and emergency room visits of the uninsured. Small businesses are already eligible for a tax credit that can reduce the cost of health insurance by more than a third; starting in 2014 the credit will cut health insurance costs in half for qualifying businesses.
These are important reforms for those of us with coverage. And because of this law, more than 30 million Americans who lack insurance will be able to get it. Samuelson claims that the insured cost more than the uninsured — a regrettable and nearsighted perspective.
How can it possibly help our nation to allow our fellow Americans to go without needed medications, tests and treatments because they don’t have insurance? Continuing to leave them out is a formula for worse health and higher costs downstream. And repeal would reward the insurance industry’s worst abuses and hurt families by weakening their coverage.
The Obama reform will control health care costs the best possible way — by helping patients get and stay well.
Donald Berwick is a former administrator of the Centers for Medicare and Medicaid Services in the Obama administration and a former president and chief executive of the Institute for Healthcare Improvement.
So you don’t like the individual mandate in the health care law.
Fine.
What would you replace it with?
Why do you think Newt Gingrich back in Hillary’s days was for it — after they had looked at everything else?
There was no way around it.
“The insurance mandate is socialism, plain and simple.”
If it’s socialism, you’d have to buy it from the government, which would also tell you what doctor or hospital to go to. But you can buy health insurance from anybody, and you can get treated by the doctor and hospital you want. What’s socialist about that?
“Can’t you see, the government is making us buy insurance. We have no choice in the matter.”
Do you have a choice not to get hurt, or not to get sick? Why then do you want a choice not to have insurance to pay for it when you do?
States in fact already have an individual mandate for car insurance, and they have been putting uninsured drivers in jail for years.
“That’s different. Driving is a privilege.”
Then free health care must be a right in your book. Maybe this idea came from hospitals continuing to treat the uninsured the last half century.
The tradeoff to us living in a civilized society is that we have to follow rules we don’t agree with. In return, we get great many things, including goods and services that otherwise would be unavailable. But, we still have to pay for them. The mandate makes sure that we do.
What’s wrong with that?
If it is such a great piece of legislation then why did The One have to give over 1,000 waivers to politically connected groups that would otherwise have had to abide by the law? I guess we ALL don’t have to “follow laws we don’t agree with”, to quote your own post above.
And here I thought we were all equal under the law. I guess this was part of the fundamental change The One promised us.
Seems to be a recurring theme with him, government by fiat. I suppose next he’ll decide who should pay taxes and who is exempt according to the wisdom of “The One”.
No, that has been the playbook of the GOP.
Wow! What a brilliant retort. Apparently you’re OK with some animals being more equal than others. That’s what always happens in socialist countries.
Pretty soon articles like this will be rare. Obamacare is on its way to extinction.
I heard of liberal people who own a small business were excited about a health plan from Obama, until it passed and they found out what it meant for them….
Unaffordable mandated health insurance to them and their employees. So it is subsidized for some, but not to all or enough to keep things sustainable.
According to a survey done last Fall nearly 1/3 of all small businesses that provide healthcare to their employees are considering dropping their plans in 2014.
The only stories I’ve heard of liberals being disappointed with Obamacare are from those who feel the law doesn’t go nearly far enough.
I have, however, heard many stories of conservatives who would have been staunchly opposed to Obamacare – except for the fact that they or their loved ones have serious or long-term medical problems which would have bankrupted them if not for the new law.
As a person with a chronic incurable disease, I cheered the day my insurance company sent me the letter that said my cap on lifetime coverage was gone. While I have done everything right as far as healthcare is concerned, I still found myself with an expensive chronic incurable disease. It requires extremely expensive treatment to keep me working, walking and contributing to my family and society, but I have not and still do not abuse my insurance. I combine required tests between doctors, ask whether they are necessary before I get them, do what I am told to do as far as treatment and still I have to watch my healthcare being used as a shuttlecock between the Democratic and Republican and Tea Parties.
We have to live with the uncertainty of whether or not we will be covered in the future, whether we will have to pay HUGE co-pays even when we have insurance, what will and will not be covered and how long we will be covered if the caps are re-instituted. It’s time to stop playing with the lives of Americans and JUST DO THE RIGHT THING AND ENSURE ALL AMERICANS ARE COVERED!
Why do liberals believe giving things away for free will help people use less of it?
Also, why do liberals believe taking from those who produce and giving it to those who do not produce will create more people who produce?
You couldn’t be more wrong. Obamacare and the mandate in particular are a solution to the free rider problem.
Insurance is supposed to cover unexpected things. The problem with Obamacare is it gets loaded with wellness stuff which is cheap per person but a budget buster when everyone gets it. That was the problem with the Mass program. People want affordable insurance, not wellness care which is cheap enough and widely available. A big difference although a simple one which explains why those given to complex solutions miss it. People want affordable health insurance, not wellness.