A reader defends the goals of the Affordable Care Act.
I understand the criticism of the Affordable Care Act (ACA), much of it justified. It is too long for anyone to read, it relies heavily on too many unproven theories (like pay for performance and accountable care organizations,) and it has the potential to make healthcare more expensive rather than less.
But while I am not necessarily a fan of all the ideas in the ACA, I am a fan of the idea of the ACA. It is folly to argue that our current healthcare system is effective or sustainable. Something must change. We have a lot of national and international examples of both success and failure and it is important to learn from these experiences. No one does it perfectly, and even good systems can be improved, but our country needs to start somewhere.
For all the valid criticisms of the ACA, it is a start. It stakes a claim on big ideas like universal health coverage, the primacy of primary care, holding clinicians responsible for more than just writing the prescription, and tying payment to quality and value.
I fully expect that portions of the ACA will be complete failures, but if we don’t start trialing these ideas, we will remain ignorant of the best way to direct our future healthcare system.
Jennifer E. Frank, MD, FAAFP