The last period in which federal legislation dealt comprehensively with the American health care system was in mid-1960s. Now, nearly four and a half decades after the passage of Medicare and Medicaid, the Patient Protection and Affordable Care Act (PPACA) has been enacted, which is significantly more comprehensive that Medicare or Medicaid and has proved to be more controversial than either. Although one could argue that Medicare affected everything in the United States’ healthcare system, few people could conceptualize how the pieces of the health care puzzle fit together (or even if they fit together).
The elections of November 2, 2010 confirmed the reality that the legislation remains highly controversial, and that many newly elected or re-elected members of the United States Senate and House of Representatives believe they have a mandate to work for the repeal or radical revision of the act. President Barack Obama in a November 3rd press conference signalled that he is willing to look at “tweaking” the legislation. Since many key elements of the act do not come into effect until AFTER to 2012 elections, there is every reason to believe that health care policy and legislation will remain a subject of public interest.
The 22nd National Conference on Primary Health Care Access, to be held April 18-20, 2011 at the Hyatt Regency San Francisco will devote several plenary sessions to PPACA and its impact.
No one disputes that the new federal legislation is comprehensive, nor that it evokes strong passions. Many subjects that would have been considered separately (if at all) in the past – financing, access, eligibility, patient care, effectiveness, accountability, medical education – are included in a single piece of legislation that apparently nobody actually planned, and few people support in its entirety. Many argue that it is likely to prove unaffordable within the amounts of tax revenues that will probably be allocated to it. On the other hand, nothing in the legislation will be easy to change.
Dr John Geyman, Emeritus Professor of the University of Washington, whose recent book “Hijacked” has received much national attention for a critical and often unsympathetic analysis of the Act will make presentation entitled “The Unfinished Business of Health Care Reform: A Critique of the Strengths and Weaknesses of the Patient Protection and Affordable Care Act of 2010”. (A five part summary of Dr Geyman’s work may be accessed at Activities of the Fellows and Senior Fellows of the Coastal Research Group: Dr John Geyman Leads Forces of Dissent Against PPACA (Chapter 5: Summary of Concerns) and in the August 2010 archives of this website.
Dr Joshua Freeman, Professor at the Kansas University Medical Center, will lead and moderate a plenary panel entitled “The PPACA Puzzle Pieces: Are they all there and do they fit together?”