Hoping for Repeal is Not a Strategy

Philip Betbeze, November 19, 2010

I'm up to my neck in surveys lately here at HealthLeaders Media. It's an annual thing in some respects. By that I mean we're putting together our 2011 annual industry survey results right now, but we've also recently launched free monthly intelligence reports that are based on surveys in which hundreds of healthcare leaders give us their opinions and insight about specific challenges surrounding the operation of a successful healthcare organization.

The report I'm working on now regards reform readiness. That is, the level of readiness hospitals and health systems have regarding the new health reform law. There's lots of interesting stuff in it, but on the whole, one broad conclusion from the survey responses struck me: Some of you are pinning your hopes for your organization's long-term well-being on repeal of the Patient Protection and Affordable Care Act.

You see massive additional government regulation, reduced reimbursements, and pressure on your margin for the foreseeable future. Those are legitimate concerns regarding the law. Perhaps you're hoping the results of the election will mean the next Congress will repeal it, and you won't have to deal with it at all. The law is certainly not in any way perfect, and several of its provisions—mainly the long-term viability of the insurance mandate and the accompanying coverage increases—seem programmed to fail as they are currently written. But it is a law. They're tough to pass and tough to repeal.

I'm not saying a full repeal is impossible, but it's unlikely. Furthermore, pinning your hopes on repeal is not a strategy, it's a bet, and the odds are not in your favor.

However, the innovative and forward-thinking among you show yourselves not by ignoring the Act and hoping the regulations that will come with it go away, but by taking the broad themes of what the law is supposed to achieve (making healthcare a cheaper and higher quality service), and focusing on ways to achieve those goals. That, by contrast, is a strategy that doesn't directly depend on regulation or reimbursement rates, and it's one that will serve you and your organizations well, regardless of whether pieces and parts of the omnibus Act are rolled back or not.

Philip Betbeze

Philip Betbeze is the senior leadership editor at HealthLeaders Media.

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