PATIENT CARE

Berwick: We Know How to Fix ACA

March 17, 2017
Issue: 

By O'Ryan Johnson

March 17--Don Berwick, a one-time administrator for the Centers for Medicare and Medicaid Services under the Obama administration, said spiraling insurance costs will not come down until America's "broken" healthcare system is fixed.

"The solution to the American health care cost problem is changing the care, not throwing away the insurance," Berwick told Herald Radio's "Herald Drive" show with John Sapochetti and Rick Shaffer. "Health care is broken. It's not insurance. It's not the Affordable Care Act. But our health care system is really not designed really well. If you have a chronic illness you get lost. We don't have high levels of reliability in care. This isn't because the doctors and nurses aren't trying hard. They are. It has to do with the fact we need to build an integrated care system. One where teamwork really matters, and actually the affordable care act has a lot of that stuff in it."

Berwick, who is with The Institute For Healthcare Improvement, said the Affordable Care Act has worked in states that make it work.

"It is fixable. The states that have taken it seriously and want to fix it, even Alaska, they've done it," he said. "There's room to adjust. If this were a time when congress could work together to make that law better, we know exactly what to do to fix it.

"You have to provide a little more protection for insurance companies, probably a little wider band of coverage, and you have to make sure that young people enroll," Berwick added. "And so states that have taken that seriously—California, for example—we've marketed really carefully to younger people, we've been able to maintain a risk pool that the overall premiums are quite affordable."

Berwick said President Trump's proposed health care fix would result in higher premiums and higher out-of-pocket expenses.

"If you want to see disaster, pass this bill," he said. "We know now, from analysis over and over again, that if this Affordable Care Act replacement bill were to pass, then the insurance markets would really implode," he said. "Premiums would skyrocket, and even more than that, out of pocket costs would soar. There was just a report yesterday on what's going to happen to out of pocket costs under the proposed law and it's draconian. Middle class would suffer. It's not just about the poor."

(c)2017 the Boston Herald