Despite Republican calls for a repeal the Act, a former Democratic insider says that a GOP sweep the White House, Senate and House Representatives in the 2016 elections would probably not result in dismemberment the law.
Peter Orszag, the Obama administration’s Director the Management and from 2008 to 2010 and Director the in the prior two years, spoke about trends affecting healthcare delivery and costs at the Institute for Economic Policy Research Stanford University.
An economist, Orszag is now Vice Chairman Corporate and Investment Banking at Citigroup. He is also a Senior Fellow at the Brookings Institution and a member the National Academy Medicine. During the Clinton presidency, he was a White House economic advisor.
Orszag said both voters and Congress have become increasingly polarized in recent years, making compromise difficult on major issues such as . That means repeal the could only happen if Republican candidates won the presidency and majorities on both the House and Senate in the upcoming election.
Even if that happened, he said, “it’s extremely unlikely that a new Republican administration would put down its markers in the first six months on repealing the , because it would cause immediate harm to people. It’s easy to say ‘repeal the ,’ but when you are taking away benefits from people that they already have, that’s very hard to do.”
A more likely result a GOP sweep at the would be incremental changes to , such as moving completely to block grants to the states, and to , encouraging more seniors to enroll in private Advantage .
Orszag said the has helped control healthcare costs, using such techniques as paying doctors and hospitals fixed amounts for procedures rather than for each rendered. But linking quality to is not easy, he acknowledged.
For emergency services, he said, research shows that costlier ER departments are likely to deliver better results for patients they serve. But for post-hospital , which accounts for a portion the total healthcare bill, there is little connection between quality and , he said.
Costs vary dramatically from one region the country to another, he noted. Services to a patient that $10,000 in Florida will $5,000 in Minnesota, with no difference in quality or outcomes, he said.