Ebola suvivor Dr. Kent Brantly is applauded by President Barack Obama
Healthcare professionals listen as President Barack Obama speaks about the government’s Ebola response
With her children sleeping by her lap, Amber Brantly, wife of Ebola survivor Dr. Kent Brantly, listens during an event attended by her husband and other American health care workers fighting Ebola as President Barack Obama speaks about Ebola
IT may have been the most influential magazine article of the past decade. In June of 2009, the doctor and writer Atul Gawande published a piece in The New Yorker called “The Cost Conundrum,” which examined why the small border city of McAllen, Tex., was the most expensive place for health care in the United States. The article became mandatory reading in the White House. President Obama convened an Oval Office meeting to discuss its key finding that the high cost of health care in the country was directly tied to a system that rewarded the overuse of care. Five years later, the situation has changed. Where McAllen once illustrated the problem of American health care, the city is now showing us how the problem can be solved, largely because of the Affordable Care Act that Mr. Obama signed into law in 2010.
The problem was that doctors in McAllen were responding to reimbursement incentives in the American health care system that rewarded activity rather than value. The more procedures and visits a doctor billed, the more he got paid. The Affordable Care Act was designed to change that. One of its provisions created the Medicare Shared Savings Program, which rewards doctors for keeping their patients healthy. Participation in the program requires primary care doctors to create networks, called accountable care organizations, or A.C.O.s, to better coordinate patient care. These networks are reimbursed for delivering high-quality care below a baseline of historical Medicare costs. In 2012, doctors in McAllen formed the Rio Grande Valley Accountable Care Organization Health Providers, and signed up for this experiment. The early results are in, and they are stunning: From April 2012 to the end of 2013, the Rio Grande Valley A.C.O. saved more than $20 million from its Medicare baseline. These changes didn’t just save money; they also improved patients’ health. From 2012 to 2013, the number of patients achieving control of their diabetes rose 11.8 percentage points. The number receiving vaccinations rose 12.2 percentage points.
I got my bone density test today. I have had serious hip and back pain for over a dozen years. Because I am one of 20% of adult asthmatics who cannot take any NSAID’s, I live in perpetual pain. Self-employed, no insurance until ACA.
I got a bone density test today – no co-pay. Because PBO made even the most basic insurance affordable AND comprehensive.
I’m seeing a chiropractor as well as regular doctors. I need some x-rays so we know how aggressive we can be with exercise and PT. If I need cartillage-building or bone-building therapy, I have insurance. thank you, PBO and Dem’s.
All I want is to be able to run up and down the stairs to do laundry. To clean my house. To have a weekend where I can clean my sewing room, throw fabric in boxes, and feel alive the next day.
I am closer to that because of ACA. Thank you POTUS. Thank you, Nancy Pelosi.
Now let’s sustain this progress and keep the Senate and take back the House.
Jane C. Timm: Study: Obamacare Helping More Youth To Get Mental Health Treatment
Young adults have a higher risk of mental health problems and substance abuse – both issues that the U.S. health care system traditionally has struggled to treat. But according to a new study, the number of high-risk youth seeking and receiving affordable care is on the rise, thanks to an Obamacare provision that allows young people to stay on their parents’ health plan until they turn 26. Two million young people now have health care coverage because of the provision, the study notes, but the biggest shift has been with youth demographics that are most at risk.
Among 18-25 year olds exhibiting signs of mental health or substance abuse problems, 5.3% more received mental health care than a comparable group of 26-35 year olds, researchers from Johns Hopkins and Harvard found in the study, published this month in the health care journal Health Affairs. The cost of care has decreased, too: Uninsured doctor visits requiring patients to pay out of pocket were down 12.4%, while the number of covered visits rose 12.9%. Three-quarters of all mental illnesses begin by age 24, according to the National Institute of Health. Before the passage of the Affordable Care Act, nearly 60% of all mental health or substance abuse care for young Americans was paid for out-of-pocket. Mental health care coverage is often prohibitively expensive, a factor that respondents routinely cite as a reason for not seeking care.
The story of Obamacare over the last year has in many ways been a story about how the various claims made by conservatives about why the law would collapse have systematically fallen apart as the Affordable Care Act has gone into effect. The website debacle was so bad that nobody was going to sign up. Actually, lots of people signed up. The net number of people insured was going to go down, not up, because Obamacare would force insurers to cancel their plans.
Nope, the uninsured rate has gone down. One of the scariest claims was that premiums were going to shoot up because only the sick and the old would sign up. Back in March, the Hill published a representative story under the headline, “O-Care Premiums to Skyrocket.” Here we are five months later, and those insurance officials have begun reporting their premium increases for next year. To put it mildly, those increases do not seem to fit the definition of “skyrocketing.”
Wendell Potter: Dire Predictions About Doctor Shortage Post-Obamacare Haven’t Panned Out
Among the many predictions of Obamacare-related catastrophe was that the law, by enabling millions to join the ranks of the insured, would force us all to wait longer to see a doctor and very possibly lead to a code blue for U.S. health care. “Doctor shortage, increased demand could crash health care system,” A CNN report warned last October. A few months earlier, a Forbes headline predicted that, “Thanks to Obamacare, a 20,000 Doctor Shortage Is Set to Quintuple.”To find out if the critics’ were prescient or way off base, Kaiser Health News reporter Phil Galewitz went looking for problems. He didn’t find many. “Five months into the biggest expansion of health coverage in 50 years,” he wrote after interviewing officials from more than two dozen health centers and multi-group practices across the country, “there are few reports of patients facing major delays getting care.”
One reason the system has not been overwhelmed is that, although we might not have as many doctors as some think we should have, we do have a rapidly growing supply of mid-level medical providers — like physician assistants and nurse practitioners — who now treat many of our health problems. It probably won’t be long before most of us are treated — and treated just fine — by a well-trained professional who doesn’t have an M.D. after his or her name. A couple of weeks ago, I sustained an injury that my wife felt was serious enough that I should either go to the ER or see my doctor. When I called my doctor’s office, I was told that while the doctor was on vacation, a nurse practitioner could see me right away. And she did. And I lived to tell about it.