The Affordable Care Act (ACA) turns two this month, and where did the time go? While many people focused on making things happen, a lot of others put their time towards a series of mad scrambles in divergent directions, mostly driven by ‘what’s-in-it-for-me’ thinking.
Political wrangling, legal challenges, media grandstanding, turf defending, and garden-variety change resistance have become the higher profile of the ACA. This is unfortunate, because the law has already triggered once difficult-to-imagine achievements among the more than 50 provisions in effect today related to quality, prevention, prescription drugs, workforce, Medicare, Medicaid, insurance, medical malpractice, and fraud and abuse. Without question there are flaws and holes in any legislation of sweeping scope that is crafted through political negotiation and trade-offs, but it is clear that significant improvements are already in place, and more are on the way.
It would be a bad idea to let two more years pass enmeshed in unconstructive conflict. Health care’s status quo is more akin to a ship taking on water. Rather than running for the lifeboats, we’ll make more progress by staying on board with system transformation and attentively working with every experienced, talented, knowledgeable and open mind to keep the system afloat.