How politics distort Americans' perception of health reform

By Tom Sullivan
11:33 AM

“Despite some shortcomings, no bill is perfect, the ACA is a good bill that the administration and its supporters in Congress should go all out to explain and sell to the American people,” the Brookings Institution’s Aaron explains (pictured at left).

Indeed, a carefully crafted slogan actually does exist in the triple aim of patient-centered care at a lower cost that improves population health.

“But that is still in a silo by itself and hasn’t been understood and adopted by all sectors, meaning obviously the healthcare industry, but also the supporting service industry, insurance, workforce development, we all need to be intertwined and everyone understand that they need to really support the triple aim goals,” says Kim Lamb, executive director of the Oregon Health Network. “Those triple-aim goals, in fact, are in everyone’s best and common good.”

What’s more, the triple aim by nature is also arguably fiscally and politically conservative.

“Absolutely. Again, this is just politicking and framing it in a way that’s black and white, good vs. evil, right or wrong,” said Kevin Pho, MD, also known as KevinMD in the blogosphere and on Twitter. “And really I think we need to come together and use both conservative and progressive ideas to solve our problems because the enormity requires ideas from both sides of the spectrum.”

[Q&A: KevinMD on the practicability of repealing the health care reform law.]

Everyone interviewed for this story, regardless of party affiliation, agreed that the triple aim is a goal worth pursuing. Even the anti-PPACA John Graham, director of healthcare studies at the Pacific Research Institute, says the triple-aim is “common-sensical, a desirable objective of any sane person. But the question is do you achieve it by increasing the central direction of the government?”

That will be among the questions facing the Supreme Court in late March when it hears arguments in the case Florida et. al. vs. United States Department of Health and Human Services, the lawsuit over the individual mandate, among other aspects of the PPACA.

Which individual mandate?
The individual mandate within the Affordable Care Act has roots both conservative and progressive. The idea dates back to the late 1980’s, with institutions such as the Heritage Foundation backing it. The Heritage Foundation, however, has since rescinded that support.

But then the Republican Mitt Romney instituted statewide health insurance during his term as Massachusetts Governor, signing the Massachusetts Healthcare Law in 2006, legislation that included an individual mandate.

And a mid-January study from the Robert Wood Johnson Foundation noted that insurance premiums could rise by 25 percent if the federal health law is implemented without the individual mandate.

“To hear the Republican candidates go against it is a little bit ironic. If you look at the concept of individual responsibility, that kind of goes hand-in-hand with the individual mandate,” Pho adds. “It shouldn’t be as controversial as it is, but I think it is a way for the Republicans to find an excuse to try and repeal the Affordable Care Act.”

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