President Obama signed the Patient Protection and Affordable Care Act (PPACA) in to law in March 2010 after a year of intense national debate. On Thursday last week, the U.S. Supreme Court upheld law, ruling that the individual mandate, which requires U.S. citizens and legal residents to have qualifying health coverage or pay a penalty, is constitutional as a tax. The ruling will have a far-reaching impact on healthcare providers, especially for those who work with underserved populations.
Welcome to Grand Rounds: the Impact of Healthcare Reform.
For this edition of Grand Rounds, Vol. 7 No. 11, we’re focusing on the impact of healthcare reform: what are the changes to healthcare delivery, utilization, quality, costs (either as a provider or a patient) and outcomes. After all, these changes affect everyone, whether you’re a patient, a healthcare provider or a biomedical researcher.
Last week, President Barack Obama nominated physician and geneticist Francis Collins as the next Director of the National Institutes of Health (NIH) . From 1993 — 2008, Dr. Collins was the first Director of the NIH’s National Human Genome Research Institute (NHGRI). He led the U.S. government’s Human Genome Project, which decoded the DNA sequence of 20,000 — 25,000 genes.
In the past, Collins’ research laboratory at the University of Michigan has identified a number of important genes, including those responsible for neurofibromatosis, cystic fibrosis, Huntington’s disease and genes for adult onset (type 2) diabetes. More recently, Collins has been a proponent of personalized medicine or genomic medicine, which leverages specific genetic knowledge for the delivery of effective healthcare. Medscape interviewed him about genomic research and personalized medicine two years ago, where he said that incorporating individualized medicine into the mainstream will necessitate a change in healthcare economics. As NIH Director he will undoubtedly have a voice in the ongoing healthcare reform debate in Washington.
In his announcement on Wednesday, President Obama said :
The National Institutes of Health stands as a model when it comes to science and research. My administration is committed to promoting scientific integrity and pioneering scientific research and I am confident that Dr. Francis Collins will lead the NIH to achieve these goals. Dr. Collins is one of the top scientists in the world, and his groundbreaking work has changed the very ways we consider our health and examine disease. I look forward to working with him in the months and years ahead.
Yesterday, the American Medical Association (AMA) and five other major groups representing doctors, hospitals, insurance companies, pharmaceutical companies and union members delivered a letter to President Obama pledging to cut the U.S. growth rate for healthcare spending by 1.5 percent each year from 2010 through 2019 . The coalition’s efforts are intended to supplement upcoming legislation aimed at decreasing healthcare costs for families, businesses and the government.
The savings — an estimated $2 trillion over the next decade — would come from changes in the public-private partnership and include:
- Administrative standardization, simplification and transparency.
- Aligning quality and efficiency incentives among providers to reduce over- and under-use of healthcare.
- Encouraging coordinated care and adherence to evidence-based best practices and therapies.
- Reducing the cost of doing business by developing technology and regulatory reform.
Although the proposed health expenditure savings is small, experts say it’s significant . The very fact that health industry leaders have stepped forward to voluntarily restrain costs is itself encouraging; these are the same groups that opposed the healthcare reforms proposed by President Clinton in the 1990s.