The new health care law has been a magnet for campaign rhetoric and grandstanding. Many republican congressional candidates campaigned on the promise of repealing health care. Now that the Republican Party has the majority in the House of Representatives what can and will they do?
There are a few ways for a federal law to be repealed in whole or in part: a new law is passed that counters the original, the Supreme Court rules that the law is unconstitutional, or a constitutional amendment.
The strategy that makes the most sense would be to find parts of the law that are particularly disagreeable, and target those for repeal. This makes a lot of sense because The Patient Protection and Affordable Care Act is a 906 page document that has been read by many people, but as the document is more thoroughly combed through, we will likely find more articles and provisions that are disagreeable. AdamMD details some of the misconceptions and difficulties that the regular population has with such a complex bill.
The Health IT provisions are going to be important in breaking down the education and information barriers and The Health Care Blog goes into some depth about the policy behind Health IT, which should not be effected much by the political shift.
One particular provision that has gotten some coverage is on page 737. The provision requires companies to report to the IRS all payments of more than $600 a year to any vendor. This does not have anything to do with health care; it was just an attempt to collect some tax dollars that the government has historically been missing out on.
Things like this are going to continue to pop up, but when most of the document is a maze, referring to different subsections of different codes, it will take a while.
TITLE II. Subtitle J—Improvements to the Medicaid and CHIP Payment and Access Commission (MACPAC)
SEC. 2801. MACPAC ASSESSMENT OF POLICIES AFFECTING ALL MEDICAID BENEFICIARIES.
(a) In General- Section 1900 of the Social Security Act (42 U.S.C. 1396) is amended–
(1) in subsection (b)–
(A) in paragraph (1)–
(i) in the paragraph heading, by inserting `FOR ALL STATES’ before `AND ANNUAL’; and
(ii) in subparagraph (A), by striking `children’s’;
(iii) in subparagraph (B), by inserting `, the Secretary, and States’ after `Congress’;
(iv) in subparagraph (C), by striking `March 1′ and inserting `March 15′; and
(v) in subparagraph (D), by striking `June 1′ and inserting `June 15′;
(B) in paragraph (2)–
(i) in subparagraph (A)–
(I) in clause (i)–
(aa) by inserting `the efficient provision of’ after `expenditures for’; and
(bb) by striking `hospital, skilled nursing facility, physician, Federally-qualified health center, rural health center, and other fees’ and inserting `payments to medical, dental, and health professionals, hospitals, residential and long-term care providers, providers of home and community based services, Federally-qualified health centers and rural health clinics, managed care entities, and providers of other covered items and services’; and
And that is the problem with health care.
Things are made more complicated than they need be, costs are exaggerated, manipulated, and created. Instead of focusing on the individuals that walk into the facility, the government should focus on the facilities that they actually have control over. Health facilities can estimate their capabilities and the government should be able to estimate the need. Then we make sure that there are enough facilities with enough funds to run properly. Instead of cost per patient, the government should be worrying about cost per facility.
Can’t it just be simple? Walk in to a health facility and talk to a nurse who actually wants to help, sends you to a doctor that checks you out, runs tests, sends you to a specialist if need be, otherwise he prescribes you treatment in the form of drugs, diet, exercise, etc. Go home, be healthy, and come back for your regular checkup.