Discussion question: topic clarification needed

¶ … Aaron E. Carroll and the subject is the future of health care through the lens of the Affordable Care Act. As we know, the ACA was passed and will have a significant impact on the shape of U.S. health care. Carroll's article starts by discussing the budget deficit and the role that health care costs play in that deficit. He then outlines many of the changes in the ACA that will affect the budget. This is important, because these changes will also affect the way that health care is delivered to Americans.

At the heart of the Act are multiple payment reforms, Carroll points out. He notes that Medicare Advantage overpayments are going to be reduced. Hospitals will be punished for re-admissions for certain conditions, something that will directly affect the way hospitals have to deal with those patients. Another key item Carroll mentions is the plan to refuse payments for hospital-acquired conditions, such as surgical site infections. Suffice to say, this increases hospital liability and decreases profitability. There are also going to be bodies set up to regulate the amount of Medicare spending, something that will affect everyone from health care providers to equipment suppliers and pharmaceutical companies. There are also going to be bodies that have the objective of finding more ways to cut costs.

Carroll covers off a multiple of issues, therefore, to illustrate how the Affordable Care Act is going to reduce waste in the health care system, and make government spending on health care more efficient. Carroll takes a positive view of the ACA when he looks at it through this lens.

My critique of the article rests on that very perspective. For a health care provider, the ACA represents significant risk and uncertainty. I feel that dealing with that risk and uncertainty is something that is going to characterize the development of the health care industry for the next decade. Carroll assumes that everything in the ACA that helps the budget is going to be good, but only when looking from the budget perspective. For a health care provider, any time the government reduces payments, that is less income. As a manager in a health care provider, I understand that we have to find ways to match those payment reductions with cost reductions. If we reduce service instead, there will be heck to pay from both consumers and from the government.