Why We Need Health Care Reform Now

Abstract

This article reviews the key provisions of the Affordable Care Act (ACA) of 2010 and explains that we urgently need health reform — and not only to insure the 6 percent of Americans that it does not attempt to cover. Under the ACA health insurance exchanges will not regulate policies obtained through an employer or large group. As a result, four related problems still plague our health system. First, access to insurance (outside the exchange) does not ensure adequate coverage or access. Second, paying for insurance burdens low-and middle-income Americans yet often fails to prevent economic hardship, or ruin, from illness. Third, America lacks the means to control spending increases that erode coverage and raise premiums. Fourth, financial conflicts of interest distort medical care practice. The article proposes first steps to resolve these problems.