April 15, 2013


A Reality Check on HealthCare Reform

We all have been hearing about the issues, challenges, and bottlenecks in the US healthcare industry and the many approaches /solutions that have been discussed and designed to tackle them.

In order to initiate a reality check, I am outlining a few pointers  published online…

  • The congressional budget estimated that this legislation would cost around $900 billion with reduction in fiscal deficit of around $120 billion over a period of 10 years.
  • It is also estimated that the act will reduce the number of uninsured by 32 million in 2019.
  • This legislation will also result in 24 million people obtaining coverage through the newly created state health insurance exchanges or HIE.
  • Approximately 16 million more people would be able to enrol in Medicaid and CHIP.
  • Savings from Medicare/Medicaid, fees, taxes, etc. will offset the cost
  • The act would also penalise insurance company for abuses, malpractices, etc.
  • The legislation has already provided tax credits to small business health plans, allowed states to cover more people under Medicaid, ensured tough actions on health care fraud, expanded the coverage to retirees, and the coverage for pre-existing conditions.
  • Insurance companies with excessive or unjustified premiums may not be able to participate in health insurance exchanges in 2014.
  • The act also extends the coverage to young adults who are dependants or live with their parents and do not have dependants.

Interestingly these pointers have given rise to some more   questions:

  • What are the execution/implementation strategies, which will play a crucial role in making this a historical act?
  • How will the immense cost burden impact insurance premiums?
  •  How willing are  the providers, payers, states, businesses, and members to adopt these guidelines?
  • How to provide  the enormous training efforts that will be required to operate and adopt these legislatures?
  • What about the information security/safety, quality check, and many more measures?

These questions require further examination… Learn more about health care solutions,here.