It is, however, a deeply flawed piece of legislation. You can't gut Medicare to pay for reform when the Baby Boomers are just starting to enter the Medicare program. And you surely can't rely heavily on low-and-slow paying Medicaid to cover many of the newly insured and expect to have enough doctors accepting those new patients.
Further, this was the time to go to a single-payer plan like much of the industrialized world, whose businesses are more competitive than many of ours because of lower health care costs. I am so tired of the "No" crowd saying that 300 million Americans aren't smart enough to take the best from other nations' plans and come up the best single-payer plan on Earth.
All that said, there's good stuff in the reform law. I believe its information technology provisions will bring substantial improvements to the industry. These I.T. provisions, many of which complement existing HIPAA and HITECH laws, by themselves would have been a substantial piece of legislation.
The HIPAA transaction standards get a facelift with mandated adoption of "operating rules" that will tighten the standards and bring efficiencies promised 14 years ago. New claims attachment and electronic funds transfer transactions, plus the long-delayed health plan identifier, will further those efficiencies--if they actually become real now.
The reform law authorizes programs to develop best practices for using I.T. to improve nursing home care and home health care. Establishment of Web-based health insurance exchanges at the federal and state levels will make it easier for consumers to compare and purchase insurance.
Development of standards and protocols to facilitate electronic eligibility verification and enrollment of individuals in federal and state health and human services programs will stop so many from falling through the cracks
The HITECH-mandated level of data exchange that's likely required by Stage 3 of the meaningful use criteria will help organizations better prepare for accountable care organizations, the medical home model of care and bundled payments that are coming under the reform law.
Still, these I.T. enhancements could have a very bumpy road to implementation. The insurance industry fought the HIPAA-mandated health plan identifier for many years so I'm real skeptical the new mandate will fair better. I see a lot of cash-strapped states declining to build a state-specific insurance exchange for their residents and instead accepting a more generic version from the federal government, as the reform law enables them to do.
And while reform I.T. provisions will compliment HITECH requirements, I see a lot of state Medicaid programs not fully paying EHR meaningful use incentives--and providers not finding that out until the lighter checks land in the mailbox. Honestly, who trusts Medicaid to pay what's promised?
As for the single-payer system it is flawed as well. Having worked for a multinational healthcare company previously I had to learn a multitude of different healthcare systems which each had their own idioms and exceptions, exemplary of a flawed system. For example, in socialized countries I didn't understand why I didn't see people who were physically challenged in public that often. After speaking with different stakeholders including Ministries of Health I was told that people who have needs are put on waiting lists for surgeries thus, some of these individuals expired before their turn came for treatment.
On another note, people who did not want to wait for their turn for care and could afford it purchased privatized health insurance coverage as a supplement and were able to fulfill a treatment.
There is a huge misnomer about single payer systems being completely covered via the government. The way this is paid for is through an extremely high tax on the public of which the financial model has been in place long enough that historically those countries' people seem to overlook due to it having been in place for a historically long period that it has become the accepted "norm."
I have to reiterate my opening line that if we don't make mistakes we aren't doing anything and to expect perfection out of the gate would never allow this country, The United States of America, to advance.
There are good ideas on all sides of the debate and if studied by the most knowledgeable people representing all sides, there will be the fewest losers - there are always those that lose when there is significant change. Right now, the taxpayers are going to be the biggest losers by far and unfortunately providing coverage for all is a LOT different than providing care for all.
P.S. Britain's National Health Service is big trouble and is talking about decentralizing.