The US Supreme Court ruling has given the green light to President Obama’s healthcare reforms. But it also highlights the need to get serious about tackling the system’s wider problems
On Thursday, June 28 the Supreme Court of the United States affirmed that the Affordable Care Act is constitutional. SCOTUS ruled that the mandate was not constitutional under the commerce clause, but it was nevertheless upheld as a de facto ‘tax’.
What this means is that people who refuse to buy insurance must pay a tax penalty. This represented a very controversial judicial decision, which has sparked a great political debate in the US. It is a landmark ruling because it outlines the federal government’s role in providing health care coverage.
At the same time, irrespective of what people think about the SCOTUS decision, it’s time for the US to get serious about healthcare reform.
The US has overpromised in connection with healthcare. In addition, it spends double per person compared to the average industrial nation, yet achieves below average societal results in many respects. US healthcare reform needs to focus on several key principles.
First, universal coverage should be achieved, but it must be appropriate, affordable and sustainable.
Second, in order to do this the federal government should focus on broad-based societal needs. This includes care that covers basic wellness, preventive and catastrophic care, not individual wants.
Third, no country can write a blank check for healthcare. All other major industrialized nations have a budget for government spending on health care, but the US does not. It’s irresponsible and unsustainable for the government to spend unlimited amounts of money on health care. Annual limits on the amount of spending on healthcare must be set.
Fourth, payment and malpractice systems should use evidence-based standards. This can be used to help reduce cost, improve quality and significantly reduce defensive medicine.
And finally, additional transparency and consumer incentives related to both healthcare cost and quality are needed. Employees need to know how much of their compensation is in the form of employer paid health insurance. Individuals also need to take responsibility for their health and have more of a direct economic stake in the cost of their healthcare.
The US can only achieve successful and sustainable healthcare reform by focusing on the above type of key principles. And the US cannot put its finances in order until it does so. It is time for a real conversation about healthcare reform, and elected officials need to realize that doing nothing is not an option.