qotd: Will King v. Burwell have a long-term impact?

Vox
June 15, 2015
Obamacare's final test: if it survives the Supreme Court, it's here to stay
By Sarah Kliff

In the next two weeks, the Supreme Court will rule in King v. Burwell, a
challenge that threatens to dismantle Obamacare by ending financial
subsidies for 6.4 million Americans.

If the challengers win, it would throw the health-care law into chaos.
But if the White House prevails, something equally momentous will have
occurred: President Obama's signature legislative accomplishment will
actually, really, definitely be here to stay.

"If we win this, I think that's major, and I'd call it a monumental
step," says Ron Pollack, executive director of the pro-Obamacare
advocacy group Families USA. "It means that the ACA is a permanent part
of the American health-care system."

http://www.vox.com/2015/6/15/8779143/obamacare-repeal-dead-supreme-court

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RevCycleIntelligence
June 15, 2015
Will Inefficient Financial Healthcare Reform Kill the ACA?
By Jacqueline DiChiara

Is the Affordable Care Act (ACA) hurling the healthcare industry further
into the red? The answer is a definite yes, according to a recent
RevCycleIntelligence.com article about key findings from a pair of
Harvard Medical School professors' Health Affairs blog study.

The bureaucracy will gobble up a quarter of federal spending; the ACA
will add almost $274 billion in new administrative costs heading into
2022, well beyond what would have been expected had the ACA not been
passed, maintain David U. Himmelstein, MD and Steffie Woolhandler, MD.

"Previous work we've done suggests that a third of the total healthcare
dollar goes to paperwork and bureaucracy," Himmelstein states. Such
numbers are likely mere underestimates that require updating, he confirms.

"Most other nations are much more efficient in the way that they finance
and administer healthcare," Himmelstein confirms. "There is no reason,
other than political difficulty, that we can't shed massive bureaucratic
costs."

Himmelstein predicts the ACA will soon lose dominance within the
healthcare industry, moving forward. "Instead of fighting about whether
to go back to an old system, repealing the ACA," he says, "the debate
will turn to how we move from here to something different, hopefully
better."

"Costs are likely to resume an upward growth pattern and more and more
people are going to find themselves grossly underinsured. All of those
problems are going to be part of the debate very soon," he says. "We are
moving to a handful of giant organizations controlling the health
delivery system, largely focusing on their own interests and giving lip
service to wanting to serve patients, but really acting like corporate
masters of the healthcare system and shaping it to do what they want
rather than what patients need," he maintains.

The simple solution is to implement national health insurance,
Himmelstein maintains. "Is it appropriate that some private organization
have the decision making power over the healthcare of the vast majority
in that region?" he asks. "Privatization is much less efficient,"
Himmelstein states. "We'll again be coming to a debate about national
health insurance."

http://revcycleintelligence.com/news/will-inefficient-financial-healthcare-reform-kill-the-aca

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Comment by Don McCanne

Everywhere you turn these days there is rampant speculation on what the
impact will be of the soon-to-be-released Supreme Court decision on King
v. Burwell - the case on whether or not subsidies can be provided to
enrollees in federal ACA insurance exchanges. In the long run, the
outcome doesn't matter.

As David Himmelstein (co-founder of PNHP) explains in the
RevCycleIntelligence article above, "Costs are likely to resume an
upward growth pattern and more and more people are going to find
themselves grossly underinsured," and "Instead of fighting about whether
to go back to an old system, repealing the ACA, the debate will turn to
how we move from here to something different, hopefully better."
Regardless of the King v. Burwell outcome, "We'll again be coming to a
debate about national health insurance."

It's absolutely inevitable.