The Affordable Care Act has many positive provisions, including new coverage for two million low-income Californians under Medi-Cal and other public coverage programs and for another two to three million who would be eligible for subsidies to purchase private coverage.

Also, people with health problems (“pre-existing conditions”) will not be denied the ability to purchase private coverage based on their health status. And it will be much less likely that a serious illness will be followed by bankruptcy.

However, the law has only a few elements to help reduce costs, and none of that will work as quickly as we need. If we are to avoid bankrupting our society, we must find ways to reduce costs while maintaining and improving the quality of care.

So what is to be done?

• Change the way we pay for health care: paying health care providers to do more things with more expensive equipment will bankrupt California.
• Squeeze out inefficiency in the system: improve the efficiencies through the proper use of modern information technology.
• Give patients real power to choose: give patients, employers and payers more access to cost and quality information so they can understand the value of what they are buying
• Innovate, innovate, and innovate some more: innovations should allow consumers to participate in their own care, promote use of cost-reducing technologies
• Coordinate the hand-off: decisions on implementing reform must be made soon by the current Administration and Legislature. Today’s leaders should focus on establishing effective governance, defining private and public sector roles, and assuring that patients are well-served by new coverage systems. We need a durable foundation to allow a smooth hand-off to a new administration in 2011.

Source: Mark D. Smith, M.D., M.B.A. June 2010, California Healthcare Foundation