William A. Bornstein: Obamacare has been important for closing the protection gap

The Chief Medical Officer & Chief Quality Officer, Emory Healthcare spoke on the topic of “Healthcare financing reform in the U.S.: Trumping the ACA and Medicare?” at the event, Transforming healthcare – health policy, digital health and data privacy: Who pays the bill? at the Swiss Re Centre for Global Dialogue. The conference, hosted by Swiss Re Corporate Solutions and Emory Healthcare, explored best practice, economics and digital security in the healthcare industry.

Read a text version of the video below:

“The United States spends more on healthcare than any other country in the world, and the rate of increase of that cost is greater than any other country in the world. The Affordable Care Act, or Obamacare, really was designed primarily to provide more Americans with health insurance, not so much to control cost. In fact, providing additional healthcare coverage for the 30 million Americans who are not covered actually generates more costs, so not a surprise to most of us, although I think some of the public were kind of thinking that perhaps Obamacare was really aimed at controlling healthcare costs. I think Obamacare was very important in terms of its goal, and that is that there were millions of Americans who did not have healthcare or insurance, and that, from my point of view, is really an unacceptable state of affairs. Obamacare was aimed specifically at addressing that, and towards the end of last year, there were 20 million Americans who had not had health insurance prior to Obamacare who did. I think that's a dramatic achievement.

There have been, like any big change, there have been some issues with it around the initial implementation of the website, how some of the exchanges have worked, some of the cost implications, but I think the answer to that is learning from what's gone well and what hasn't, and making adjustments. President Trump's executive on the Affordable Care Act was a bit vague, and we're not really sure what it's going to mean, so we've not shifted at all in response to that. What's going to be more important is what, if anything, happens to the Affordable Care Act? Is it going to actually be repealed and replaced or repaired? We continue to believe that shift from fee for service to value-based reimbursement is the trend. There seems to be bipartisan support for that, so that's our emphasis, is on preparing for that shift.”