Healthcare Reform Unstoppable, Regardless of Court's PPACA Decision

Update: The Supreme Court Thursday upheld the Patient Protection and Affordable Care Act by a vote of 5 - 4. The individual mandate provision survives as a tax. 

When the U.S. Supreme Court makes public today its long-awaited ruling on the constitutionality of the Patient Protection and Affordable Care Act it will go down as a seminal day in the high court's history. It may even affect the outcome of the presidential election in November.

Whatever the ruling, however, it will have a limited effect on healthcare's soaring costs, and no effect in the short term. That is because many court watchers, legal scholars, politicians, and media bloviators looking through the narrow lenses of their own expertise and biases incorrectly view healthcare reform as a battle to be determined in legal or political arenas.

Most people inside of healthcare know that the politics, histrionics, and legal wrangling over "ObamaCare" are sideshows. The need for healthcare reform is being driven not by some socialist agenda but by money and the relentless increases in healthcare costs that are crippling other sectors of the economy.

The cost of healthcare in the United States, closing in on $3 trillion annually, will soon equal about 20% of gross domestic product, which is roughly twice as much as healthcare spending in any other industrialized country. That is unsustainable.  

"Regardless of what the court decides, healthcare in this country is already changing and must keep evolving, because it's broken," Chris Van Gorder, president/CEO of San Diego-based Scripps Health said in a media statement this week. "This crisis presents a challenge and an incredible opportunity for physicians and hospitals to fundamentally reshape the future of healthcare."

Depending upon the forecaster, healthcare spending growth is projected to increase between 4% and 6% or higher in the next year and beyond, which well above the 2.3% rate of inflation as measured by GDP. Those rising healthcare costs will be reflected in the higher insurance premiums, deductibles, and co-pays for millions of Americans, along with the burden employers face carrying increasingly expensive coverage. That's money taken out of the economy for discretionary spending.

It is no coincidence that wages are stagnant but healthcare costs are not. Today's decision by nine justices won't affect that at all. It seems the biggest effect the PPACA legal battle has had is not with how the high court will rule, but with the months of uncertainty that has left many healthcare providers to wait for the dust to clear.

Patricia Webb, senior vice president and CHRO at Catholic Health Initiatives, told HealthLeaders Media back in April that the Denver-based health system could not afford to wait on the high court's ruling. "At the rate healthcare costs are growing we had to modify how we take care of patients and focus more on population health and preventive care that is going to happen and that is what needs to happen from our perspective," Webb said.

"It is driven more by the economics of it and, if for some reason, the Affordable Care Act is not passed and whatever happens, the population is still going to need to access healthcare and we have to be in a position to provide it," she said. "The best way to do that is to do it in a way that provides the quality that needs to be provided, with appropriate access in a cost effective way."

Rather than relying on a federal mandate or a Supreme Court ruling, Van Gorder says the solution to fixing the healthcare system is to focus on the patients rather than the providers or the payers. "That may sound obvious, but it could be argued that the current system was built for providers, not patients," he said. "If we do what's right for patients, we're never going to be wrong."