Instead, the discussion has centered almost exclusively around access issues and consumer payments. It seems to be all about the legal arguments regarding coverage, and states' rights to care for the poor the way each state sees fit.
Like how much the public must spend to buy commercial insurance, how each state will create an exchange, what the fed's role will be in assuring that states do, how much in taxpayer dollars will be spent on subsidies, and who will be required to buy health insurance.
Almost nowhere do I hear mentioned that within the act's 974 pages are provisions imposing greater pressure on hospitals to reduce high 30-day mortality rates and 30-day readmission rates, which signal poor discharge planning and healthcare provider follow-through.
I’m hearing zilch about the law's requirement that how providers who are paid should be tightly linked with whether care was delivered according to the latest scientific evidence.
There's scant mention on the blogs or other media of the fact that the ACA penalizes hospitals whose patients suffer higher rates of preventable conditions such as falls, infections, or other serious medical errors. Or that it sets forth a process for establishing measures by which one can compare hospital emergency rooms, cancer care, ambulatory surgical centers, home health agencies, skilled nursing homes and patient experience, many of which are tethered to hospital payment determinations.