Author: John McDonough

I offer insights and opinions on how to improve health care systems for everyone

Explaining ObamaCare to Foreigners

I wrote this column for Commonwealth Magazine on the 5th anniversary of the ACA’s signing on March 23.  In case you did not see it, there are messages in here helpful to Americans in understanding this massive policy change.  Let me know what you think.  One correction: the decline in some hospital acquired conditions referenced near the end of the column can be traced to the early 2000s and has accelerated significantly in the past five years.

Here goes:

On the fifth anniversary of the signing of the Affordable Care Act, I ponder how 1 ACAOCnon-Americans view our momentous and controversial health reform law. Like many US health policy analysts, I get requests from groups outside the US to explain the ACA, or “Obamacare.” I have traveled to Brazil, Australia, and South Africa, and also addressed foreign audiences here in the US, to explain what they should they know about the law and why they might care. I offer them two conclusions, and believe Americans might benefit by knowing them. They are: we remain laggards in providing access to health care coverage, and we are now real leaders in global efforts to improve health care’s quality, efficiency, and effectiveness.

First, when it comes to providing universal coverage and financial protection from the costs of illness and injury, non-Americans have almost nothing of value to learn from us. Even after the ACA’s health insurance expansions are fully implemented by 2016-2017, the US will still have the most inefficient, expensive, wasteful, and unfair coverage system of any advanced nation on the planet.

Long before President Obama signed the ACA in 2010, every other developed nation had established a system to provide universal coverage for all their citizens. Each found its own idiosyncratic path, using differing measures of market and government intervention to align with their distinct economic and political cultures. They all did it better than the ACA ever will. Continue reading “Explaining ObamaCare to Foreigners”

Reheating Health Stew

Health Stew John 300x300_editedAbout 12 months ago, I suspended writing this blog, Health Stew, which I had produced since late 2011. The original site for the Stew, boston.com, ended their Community Voices series, and I had some big work commitments that convinced me to take a hiatus.  I also, naively, believed that in 2014, after implementation of the big access expansions of the Affordable Care Act were done, that health policy would, finally, get boring again.  Boy, was I wrong!

So after a year off, I’m back with the Stew as an independent blogging site for me, and I hope for others looking for a nontraditional and nonaligned site for commentary and analysis on health policy and politics in Boston, Massachusetts, the US, and around the globe.

Why do this?  I do this because I feel a need to add my voice to those who seek to advance a fairer, more just, more equitable, smarter, and better health care system for all Americans.  I don’t — and can’t — pretend to be neutral when it comes to the Affordable Care Act — or ObamaCare.  I was one of an army of Congressional staff who worked on the writing and passage of the law between 2008 and 2010. I wrote a book about the ACA called Inside National Health Reform to help people understand both the process to passage and the substance of this most important federal law.  I believe in health reform as a continuous process that never ends and, we can hope, gets better.

I chose the name Health Stew because I like stew and I like the image of a lot of ingredients coming together to produce a nutritious and tasty dish with an attractive aroma.  My interests in health policy are wide ranging and include access, quality, costs, public health, health inequities and disparities, health politics, history, economics, psychology, sociology, law, finance, and much more.

If you want to catch up, you can check out all my earlier Health Stew posts by clicking here.  They are reverse chronological, and my advisers and I are trying to figure out how to make them all more easily searchable and categorized.  Stay tuned.

My special thanks to Jennifer Powell from the Excellent Writers Group for her great consultation and support, as well as to Tania Helhoski for her graphic design.

So much to talk about !  Let’s get started…