The wide range of care now seen between rich and poor will narrow with increased numbers of insured citizens but part of the change will be reduced services to upper-middle class patients. The really rich will be able to have real private care but may suffer reduced confidence that they have the most competent providers.
Progress Report on ACA Finds More Covered, But Warns on Costs of Care — Physician’s First Watch
Progress Report on ACA Finds More Covered, But Warns on Costs of Care
By Joe Elia
A useful overview of the Affordable Care Act and its effects so far on U.S. health care offers three conclusions.
First, coverage has expanded. The Congressional Budget Office estimates that the ACA will decrease the number of uninsured by some 12 million this year.
Second, in those states not accepting expansion of Medicaid eligibility, it's estimated that some 5 million uninsured people will remain without insurance, although it's expected that most states will eventually accept the expansion.
Finally, coverage expansion is being made affordable, in part, through the use of restricted networks of providers. However, that strategy's usefulness will evaporate in the face of increasing costs of care. Innovation in delivering care "is the next great challenge facing the nation."
The overview's authors, writing in the New England Journal of Medicine, are both members of the Commonwealth Fund, a nonpartisan foundation.