From the nobody knows nothin’ files: ACA confusion
by digby
Imagine if they’d been able to just extend the existing Medicare program to everyone:
[A]t the recent AcademyHealth National Health Policy Conference, where state and federal officials and interest groups lined up to present long lists of policy questions that confront them as they grapple with implementation of the Affordable Care Act and mounting public budgetary pressures.
For instance, in the “Opportunities & Challenges for State Officials” session, New Mexico’s Medicaid Director Julie Weinberg described the unknowns surrounding how “churn” between private and public coverage will change and how new Medicaid eligibility standards will impact enrollment processes.
Patty Fontneau, the executive director of the Colorado Health Benefit Exchange (Colorado’s health insurance exchange), outlined the challenges involved in providing decision support to consumers to assist in the selection of a plan from many often-confusing choices.
Something these many challenges have in common is that they are difficult to solve and all require good evidence to shape rational, effective policy.
Yet, throughout the conference venue, policy leaders seemed to lack the detailed evidence as well as a systematic way of locating and acquiring that relevant evidence from across a national research community.
When Lisa Simpson, president and CEO of AcademyHealth, asked top congressional staffers in the Congressional Plenary how researchers could better feed evidence into the Washington policy process, there were few specific or concrete answers.
I wasn’t surprised. In the past, when I’ve asked other elected officials or legislative staff how they get information, they say it usually comes down to a small network of personal relationships. The process of outreach is more often focused around building political consensus through stakeholder engagement than gathering scientific evidence. This strikes me as a very incomplete and imperfect way to shape policy, particularly considering our public investment in research.
The complexity of the program isn’t the only problem, or the fact that the people who have answers aren’t readily identifiable, if they exist at all. The post goes on to explain that even in the best of all possible worlds, there exist few processes to properly determine efficacy and nobody knows where to turn to find them.
This argues for something less complex in my mind but then that’s my bias anyway, so perhaps that’s not really relevant. The problem for the average person is mitigated by the fact that most people are covered either by their jobs, government and veterans insurance programs Medicare of medicaid. These issues are unlikely to impact them in any obvious way. But it certainly appears that the people who are administering these new programs have their hands full just understanding what they are, much less how they will work. Should be a very interesting era. Lord help them if it doesn’t end up saving money … er, bending the cost curve.
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