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Important resource: “A Five-Year Assessment of the Affordable Care Act”

A Five-Year Assessment of the Affordable Care Act

By John P. Geyman
International Journal of Health Services, February 10, 2015

Abstract

The Affordable Care Act (ACA) was enacted in 2010 as the signature domestic achievement of the Obama presidency. It was intended to contain costs and achieve near-universal access to affordable health care of improved quality. Now, five years later, it is time to assess its track record. This article compares the goals and claims of the ACA with its actual experience in the areas of access, costs, affordability, and quality of care. Based on the evidence, one has to conclude that containment of health care costs is nowhere in sight, that more than 37 million Americans will still be uninsured when the ACA is fully implemented in 2019, that many more millions will be underinsured, and that profiteering will still dominate the culture of U.S. health care. More fundamental reform will be needed. The country still needs to confront the challenge that our for-profit health insurance industry, together with enormous bureaucratic waste and widespread investor ownership throughout our market-based system, are themselves barriers to health care reform. Here we consider the lessons we can take away from the ACA’s first five years and lay out the economic, social/political, and moral arguments for replacing it with single-payer national health insurance.

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Will the ACA be different, and if so, in what ways? And if it won’t work, what next? These are the questions we will deal with in this article, drawing from my just-published book, How Obamacare Is Unsustainable: Why We Need a Single Payer Solution for All Americans. The goals of this article are three-fold: (a) to compare the goals and claims for the ACA with its actual experience in the areas of access, costs, affordability, and quality of U.S. health care; (b) to summarize lessons we can already take away from its first five years; and (c) to briefly consider economic, social/political, and moral arguments for replacing the ACA with NHI.

http://joh.sagepub.com/content/early/2015/01/24/0020731414568505.abstract

Full Text (PDF - 17 pages): http://joh.sagepub.com/content/early/2015/01/24/0020731414568505.full.pdf

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Comment:

By Don McCanne, MD

In this paper, John Geyman summarizes the content of his important new book, “How Obamacare Is Unsustainable: Why We Need a Single Payer Solution for All Americans.” It is already clear that the Affordable Care Act has not and will not provide adequate repairs to our fragmented and dysfunctional health care system. Rather than inflicting more suffering by continuing this flawed experiment in health policy, we should immediately begin the transition to a system that will work - a single payer national health program.

Both this IJHS article and his book serve as important resources in educating the nation on why this transition should be initiated as soon as possible. They should be distributed widely.

The book is available through the PNHP website here.