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The real question is not whether to repeal the Affordable Care Act. Political rhetoric aside, leaders on both sides realize the importance of some of its benefits (covering preexisting conditions, for instance), and its initial steps to curb costs in Medicare. These provisions are here to stay.
The real question is how to further curb costs and ensure coverage is within reach for all. It is possible to do both. Republicans and Democrats may seem miles apart today, but they have an example in Medicare, which was passed with bipartisan support and adjusted over time by leaders in both parties.
Similarly, in the coming fiscal debate over deficits and debt, we can’t afford to rehash the same all-or-nothing argument between the new law and Republican proposals to give states block grants for Medicaid and to implement a premium-support model for Medicare.
The National Coalition on Health Care has worked with the consumer, provider, health plan, and business communities to chart a new course that controls costs and provides affordable care to all. Here’s what we learned:
Medicare reimbursement and coverage policies have to change. Provider payment must transition from a fee-for-service model that rewards tests and procedures, to one that supports coordinated patient care. Benefits must show good value by lowering enrollees’ co-pays and deductibles when they choose high-quality providers and more effective treatment.
Reform, however, cannot stop with Medicare or other public insurance plans. We must bolster cost-saving competition in private hospital and pharmaceutical markets. To combat chronic disease, we must strengthen public investment in prevention programs and the primary-care workforce.
After the election, Congress will stand face to face with the “fiscal cliff” and the need to cut growth in costs. Our coalition will make specific recommendations then. For the sake of affordability and better care, let’s readjust, not re-argue, health care in America.
John Rother is the president and chief executive officer of the National Coalition on Health Care.
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