Observations Yankee Doodling

Obamacare’s rocky road

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6805 (Published 12 November 2013) Cite this as: BMJ 2013;347:f6805
  1. Douglas Kamerow, chief scientist, RTI International, and associate editor, BMJ
  1. dkamerow{at}rti.org

Is there more good than bad here? Who benefits and who suffers?

Health reform has been in US headlines almost every day for months. In September and October the scuttling of “Obamacare” was the major bargaining chip the Republicans tried to use in their battle with the Democrats over shutting down the federal government and raising the debt ceiling. When that failed and they had to relent and reopen the government, the Republicans changed their focus from killing Obamacare to spotlighting the problems people have had trying to sign up for it through the HealthCare.gov website.

Given all that has happened, can the Patient Protection and Affordable Care Act (Obamacare) actually protect patients and make care more affordable?

To answer that question a bit of background is in order. Obamacare was enacted in 2010, with no Republican support and no fine tuning of the law between the two houses of Congress.1 As a result, the mammoth law, which was enormously complex and comprehensive at best, is full of minor (and some major) problems and inconsistencies.

Then the Supreme Court …

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