On Monday, October 28th, 105 Skidaway Abigails and guests met at the Messiah Lutheran Church to hear Blake Caldwell, MD, MPH speak about the Affordable Care Act. Blake is a physician and scientist (and Landings resident) who retired in 2010 from the Center for Disease Control and Prevention. She is a pediatrician but her early career included eight years in the Navy doing bacterial research. She joined the CDC in 1989 and her long career there included epidemiological research in HIV, health quality care and health care policy.
The emphasis of her talk was on how the Patient Protection and Affordable Care Act makes changes in the delivery of health care. At present, the U.S. spends more on health care than any other developed country but the outcomes do not match the costs.
Blake outlined five key themes of the A.C.A. The first of these is expanded coverage. By 2014 the number of uninsured will drop by 18 million. When states do not opt for Medicaid expansion it will negatively affect the health care of those who are Medicaid eligible.
The A.C.A offers new consumer protections and choices. It guarantees coverage for those with pre-existing conditions, prohibits “rescission” (dropping coverage), bans lifetime limits, and expands consumers’ rights to appeal denials. The law also makes health care more affordable by offering subsidies through the Exchanges, closing the “donut hole” in Medicare, decreasing the cost of medicines next year, and requiring rebates for consumers if insurers spend too little on health care.
Improvement of health care quality and controlling costs are important goals of the A.C.A . New organizations such as the Patient-Centered Outcomes Research Institute will test the efficiency of new drugs, medical devices, clinical tests and medical proceddures (compared to those in use). The new agency will not itself do any testing. It will only assess the vilue of new tests and deveices which have been introduced to the public.
The new Accountable Care Organizations will coordinate care to Medicare patients and avoid duplication of services while preventing medical errors. Providers in this program will share in the savings it achieves for the Medicare program.
The formation of Patient-Centered Medical Homes will provide access to “one stop shopping” for patients. This not only improves care, but will save money.
Finally, the A.C.A. calls for the formation of the Independent Payment Advisory Board. This has been attacked as being the infamous “Death Panel” and has been accused of rationing care when in fact this Board recommends to Congress measures for lower cost care options.
According to the Congressional Budget Office the net effect of the A.C.A will be a deficit reduction of $143 billion over the next decade. In contrast, $109 billion would be added to the federal deficit if the law were repealed.
In summary, the A.C.A. changes everything. “It begins the journey of paying for health and good medical outcomes….most importantly, it offers hope for millions to obtain affordable care, and removes the terror of financial ruin that currently accompanies a serious illness for many American families.”
Blake’s presentation was enthusiastically received and was followed by a brief Q and A.
Reported by Joyce Lopez
