At its core, Obamacare has one main goal: delivering affordable health care to most Americans. And now that the U.S. Supreme Court has ruled in favor of one of its key provisions, the health-care overhaul should continue working toward that goal — at least until the next president and Congress are sworn in. It has been five years since the Affordable Care Act (ACA) became law, and new data and numerous real-life stories are beginning to reveal how close or how far the ACA has come toward meeting its objective in Washington state.
In 2013, nearly 900 Medicare beneficiaries were discharged from three Lancaster County hospitals after having major joint replacement surgery. Medicare ultimately paid the hospitals — Lancaster General, Ephrata Community (now Wellspan Ephrata Community) and Lancaster Regional Medical Center — all roughly the same amount for the procedure: between $9,500 and $10,500. But the amount the hospitals had asked the federal government to pay varied wildly. At Lancaster General Hospital, the county's largest, the average billed amount was just less than $35,000. At Ephrata Community, this "average covered charge" — akin to "list price" — was $37,574.
A lot of the hospitals in rural Kansas are called "critical access
hospitals." It's an important designation that the federal government created to maintain access to health care in rural areas. But many Kansas critical access hospitals are in financial trouble. Although Medicare requires them to offer 24-hour emergency services, most don't have enough ER patients to justify that cost, said Melissa Hungerford, senior vice president for health care leadership at the Kansas Hospital Association. "Keeping staff and supplies and equipment and buildings and all of the facilities that it takes to deliver that around-the-clock, quality inpatient care is an expensive system," she said.
Desperate to attract mental health care workers, clinics in rural and other underserved parts of Texas have gotten creative in their hiring tactics — touting benefits like fresh air and low crime rates. Soon the state of Texas will offer another incentive: cash. Lawmakers this year created a program —at a cost of nearly $3 million over the next two years — that will help pay off mental health professionals' student loans if they practice in an underserved area. The loan forgiveness program seeks to alleviate the state's shortage of mental health professionals — including social workers, psychologists, counselors and psychiatrists — by luring them to parts of the state that have significant need for health care but may not be attractive to graduates of expensive professional schools.
The U.S. health care system is often compared to European systems in unflattering terms, yet European countries are also under increasing pressure to increase their quality of care and efficiency. Many are looking to the United States for innovative, proven solutions. There is much that we can learn from each other. A newly formed collaboration involving Utah's Intermountain Healthcare and the French government is providing one vehicle for that learning. Last February, senior leaders from Intermountain were invited to France to meet with that nation's top health care officials, including the French vice-minister of health, senior government health policy leaders, physicians, and the leader of health insurance for the Paris region.
Health insurers Anthem Inc. and Cigna Corp. are in talks to combine after Cigna last month spurned a $47.5 billion takeover from Anthem, according to a person familiar with the matter. Representatives of the companies met Friday and Tuesday to discuss a potential tie-up, the person said. A deal could be reached in coming weeks, the person said, though there is no guarantee the latest round of talks will result in a tie-up. Anthem has been trying to combine with Cigna for nearly a year, but the two companies have struggled to agree on price and other terms, including who would run the combined company.