The most groundbreaking, and comprehensive reform in healthcare was signed into law by President Barack Obama today, less than 48 hours after the house passed it. One side is decrying the legislation and claiming the ruination and destruction of the known universe. The other side is claiming that healthcare reform has finally been achieved.
As usual, they are both wrong. There are three distinct and separate components to healthcare reform, and this only addressed one of them. By no means, am I trying to diminish the symbolism of this achievement, but would rather caution that this is but the first ten miles of a grueling marathon.
I noted that President Obama was careful with his language today, and called this the "most comprehensive piece of health insurance legislation ever passed".
We still need to address healthcare financing reform (ie; how do we PAY for healthcare?) which this does to a very partial degree, but only through subsidies that remain somewhat murky as to the details of their financing.
The biggest hurdle, is perhaps the most important one. We desparately need healthcare delivery system reform. We need to reform the way that care is delivered. We need to develop strong comparative effectiveness data. We need to reduce the primary care income disparity gap, and we need start paying for value. We don't do this now. We pay for volume. We pay for quantity, not quality.
So there is still much to be done, and I will be on the front lines, carrying the banner of the PA profession into the fray.
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