PPACA's Impact on Quality of Care Isn't Getting Its Due

Cheryl Clark, for HealthLeaders Media , July 12, 2012

"But I think more important," he said, "we are communicating that the Medicare program has changed fundamentally, to keep beneficiaries well and to keep them healthy...The Medicare program has shifted from a program that cares for beneficiaries when they're sick but also to one that keeps beneficiaries well and healthy and focuses on their patients needs to the greatest extent possible."

Aside from the U.S. House of Representatives 31st attempt on Wednesday to repeal the act, this legislation still has a long way to go. (The bill was approved by a vote of 244 to 185. It is not expected to be approved by the Senate.) As Atul Gawande, MD, said in a recent article in the New Yorker: "Many levers of obstruction remain; many hands will be reaching for them."

The administration can and should be much more out in front about the legislation's mandates to improve quality with as much forcefulness and gravitas—preferably even more so—to explain how this legislation doesn't just deal with money and coverage. In so many very specific ways, it holds the promise to actually improve health and prolong life.

Why is that something to hide?

Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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8 comments on "PPACA's Impact on Quality of Care Isn't Getting Its Due"

Todd (7/19/2012 at 9:19 AM)
The legislation surrounding improving quality is a nonstarter. Hospitals will simply further cost-shift to employers to pay for their penalties associated with readmission and other expenses. Competition with other hospitals, especially international facilities to attract patients will improve care long-term, not some absurd government mandate. Government never does anything well.

Alton Brantley (7/13/2012 at 3:09 PM)
As Mark points out, the Supreme Court was asked to determine 2 things: First, could Congress impose the individual mandate, and second, could HHS withhold Medicaid funding if states do not participate in PPACA. Their ruling was solely on these two questions of law, not on any issue of healthcare. For the first issue, SCOTUS ruled that the mandate is a tax (filed by tax return, leveed against taxable income and approved deductions, and collected by IRS). Second, Congress has by the Constitution the right to levy taxes. But they denied that it fell under the Commerce clause. So the health insurance tax stands. For the second issue, SCOTUS ruled that failure to participate in the Medicaid expansion could not be penalized by withdrawal of current Medicaid support. (States rights vs Federal enumerated powers).

MkWs (7/13/2012 at 12:29 PM)
Hi Cheryl, These are things to hide because the public doesn't want to take the time to understand anything that doesn't fit in two paragraphs, political careers are no longer made on success but opposition, only policy wonks and clinical and research people understand the ins and outs of the topic of quality and how woefully inadequate it is, and finally because anyone who suggests our tech-driven, high-touch, expensive, and well-salaried system is already anything but the world's best and is in need of improvement suddenly finds themselves in a room full of deaf ears. How about that for a few reasons? Wish it weren't so but I believe that aptly describes the environment for today's discussions on PPACA and the state of US health care today. Thank you for writing the article and bringing attention to a question that has been on my mind as well since mid-2009. Mark Wesson




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