What Are the Chief Flaws in the ACA?


In addition to being complex and hard to understand for most people, the ACA has several other substantial flaws, including a failure to cut costs to the extent its supporters claimed it would.

(Click the play button on the audio player above to listen to this segment of the ACA panel discussion)

This HCPLive audio panel discussion features:

  • Joel Zinberg, MD, JD, Associate Clinical Professor of Surgery at Mount Sinai Hospital in New York City
  • David Sandman, PhD, Senior Vice President of the New York State Health Foundation
  • Patrick Cronin, New Jersey organizing director for “Get Covered America” a nonprofit with a federal contract to help people sign up for coverage
  • Tom Wilson (moderator), a partner at Kaufman Zita Group and former chairman of the NJ Republican State Committee

The panelists look at how well the ACA is working and discuss whether it is politically vulnerable.

To Zinberg, the act fails to deliver on keeping costs down. “It’s called the Affordable Care Act, but it does virtually nothing to control costs”, he says.

One of the built-in mechanisms to do that was to be setting up a board to review costs. That has not happened—but on the other hand, Sandman says, national spending on health care has slowed.

The panelists agree that US health care is costly, as seen in the chart below.

To Cronin, the ACA’s shortcoming is that newly insured or uninsured consumers have a hard time understanding how it works. Lower premium cost would be an improvement too. The ACA promotes “accountable care organizations” (ACOs) or large networks usually run by hospitals which focus on setting guidelines for care and cutting costs. But these experiments have been disappointing in terms of cutting costs, the panelists agree.

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