Many months before Bernie Sanders entered the presidential race, we (along with Dr. Adam Gaffney, an energetic younger colleague, and Dr. Marcia Angell, the former editor of the New England Journal of Medicine) convened a nonpartisan group of 39 leading physicians to envision health care reforms that would fix the glaring problems that remain despite the Affordable Care Act (ACA).
After the Supreme Court removed the final roadblock to the law in 2015, President Obama declared that at last “in America, health care is not a privilege for a few, but a right for all.” Yet doctors on the ground knew that wasn’t entirely true. We continue to see patients who dangerously delay their care because of cost concerns or insurance obstacles. At least 27 million Americans remain uninsured, and for tens of millions with insurance, sky-high copayments and deductibles (which average $5,300 in the bronze plans sold on the ACA exchanges) mean they’d be bankrupted by a serious illness. Many more people have narrow network coverage that won’t pay for care at top cancer centers or academic hospitals.
Meanwhile, giant insurers and hospital conglomerates with a single-minded focus on their bottom line increasingly dominate health care. And doctors and nurses contend with insurers’ growing demands for mind-numbing electronic documentation. These trends predated the ACA, but the law accelerated them. The ACA has also fueled medical merger-mania and the health system’s administrative complexity and cost. For the full article click here
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