The end of the year is always a good time to reflect on what went right and what didn't and to speculate about what might happen in the coming 12 months.
So let's take a look at how the U.S. health care system changed in 2014 -- the first year of close-to-full implementation of Obamacare -- and take note of what we need to address sooner rather than later as we get ready to ring in the new year.
There is plenty of reason to celebrate and, as you can imagine, the White House wants us to believe that we can thank the Affordable Care Act for all the good things that happened. While I'm willing to give the law its due, the reality is that, as written, it will never get us to universal coverage or do nearly enough to control health care costs. But first, some of the good news:
- As the number of newly insured Americans reached an estimated 9.7 million this year, the percentage of Americans without coverage fell to the lowest level it's been in years. That's according to the National Center for Health Statistics, which released data last Thursday showing that the percentage of uninsured Americans dropped from 14.4 percent in 2013 to 11.3 percent in the second quarter of 2014. The White House Council of Economic Advisors says that's the largest drop in at least four decades. The last time so many people gained coverage in a single year was when the Medicare and Medicaid programs began enrolling folks in 1966. The current gains were made possible by provisions of the Affordable Care Act that make it illegal for insurers to turn down applicants because of pre-existing conditions, as well as the availability of federal subsidies that help millions of Americans with their premiums and out-of-pocket spending.
Those are all good reasons to cheer. But other studies indicate just how much more there is to do.
- Even with the slowing of health care inflation, the U.S. continues to spend far more per person than any other developed country. In fact, the U.S. spends two-and-a-half times more than the average of the 34 countries in the Organization for Economic Co-operation and Development. No other country comes close to spending almost 18 percent of gross domestic product (GDP) on health care, as we do. And numerous studies continue to show that America lags most of the other OECD countries in health care outcomes and metrics such as longevity and infant mortality.
In the coming year, I'll be looking at what some states and the private sector are hoping to do to at least partially resolve some of these problems. So stay tuned. And happy holidays.