Update It could have been the setting in Vero Beach, Fla., or that in his support of the law he acknowledged many of its flaws. But Geisinger Health System CEO Dr. Glenn Steele along with teammate Partners Healthcare CEO Dr. Gary Gottlieb failed to convince an audience assembled at Riverside Theater that The Nation Needs the Affordable Care Act last night.
They lost to opponents author Steve Brill, who memorably penned a Time magazine article highlighting the problems caused by a lack of price transparency in the American healthcare system and Avik Roy, a senior fellow with Manhattan Institute by a vote of 67.5 percent against compared with 27.2 percent in favor.
Steele opened up by pointing out all the things the ACA wasn’t, which some may have interpreted as a sign of weakness.
“Is ACA the complete solution to our healthcare access, quality and cost problems? Of course not. Is ACA a consensus political step forward? Was ACA sold to our citizens honestly? No. Is it understandable? No. Is it easily transacted? Obviously not.”
In a memorable point illustrating the complexities, he said: “ACA is like the Bible,the Koran and the Torah: long, complex, written in a foreign language, infinitely changeable by administrative fiat and rarely read all the way through by anybody.”
But listening to his avuncular delivery, I wondered where were the examples of the programs Geisinger has initiated to improve outcomes that helped put it on the map?
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
If anyone is well positioned to give examples in defense of the Affordable Care Act, surely it was the head of a health system that President Barack Obama pointed to as a role model for healthcare reform.
Update Although I missed it when I listened to the debate, a reader pointed out that Steele actually did reference a couple of those examples including ProvenCare Heart and Hip program and its collaboration with Walmart for employee care.
Steele and Gottlieb also failed to answer how the health system will cope by adding millions to the system even as the number of doctors goes down. Update Steele did say that team-based care could solve this through patient-centered medical homes.
Brill held the position that he wasn’t opposed to healthcare reform but that ACA does little to improve price transparency, which he sees as the biggest problem facing our healthcare system. Roy focused his argument on framing Medicaid as a model of inefficiency and questioned the wisdom of expanding that program. He also convinced the audience, if they didn’t believe it already, that were paying higher premiums for a broader benefit that’s not clear to most people.
Ultimately Gottlieb and Steele had to defend the goals and vision of the Affordable Care Act which proved to be a lot more difficult than the shortcomings everyone, including them, see in the current version of the law. It was an interesting discussion which definitely merits an ongoing frank discussion as the law evolves.
[Photo credit: Winners and losers from BigStock Photos]
