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.
On the fifth anniversary of the signing of the Affordable Care Act, I ponder how non-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”