Obamacare: time to engage pharma's core
This article was originally published in Scrip
The bomb may have been defused but implementation of the Affordable Care Act (ACA; Obamacare) in the US faces a continuing uphill struggle.
A leading Republican called on 22 October for weekly reports on how many people were signing up to the HealthCare.gov gateway, and how the creaky software on the site is holding up. Senator Lamar Alexander said there should be "no more hiding the damage of the train wreck."
Back in January 2013, Scrip's Washington Editor Donna Young flagged up the likely rocky path that faced President Obama and the ACA in the president's second term. She wrote of "the continuation of many difficult problems and … the start of the clock ticking away on [the president's] dwindling power in a toxic Washington atmosphere."
And so it has proved.
The headlines recently have all been about the damaging brinkmanship of linking decisions on to US debt which have to be approved in Congress to further ACA revisions. That link has now been decoupled, at least for the time being. But the circumstances that have prevailed during the forging of Obamacare have been far from those needed for such a huge and complex undertaking.
For instance, the critical facilities of many of the best minds in the healthcare environment have not been engaged in ensuring that the details of implementation were fully thought out, or carefully supervised and monitored. Instead, they have been deployed destructively in building sharp inclines, bending rails, and keeping the train waiting at signals.
There is nothing wrong with criticism, of course, but many ACA critics have simply carped from the sidelines. They have not engaged positively in helping create or facilitate a better Obamacare: they have placed rocks on the track and now they are expressing surprise (and perhaps delight) that the steam-driven edifice has lurched from the rails.
When those who know most about the delivery of healthcare obstruct the delivery of healthcare, patients lose crucial allies. It's time to drop the political posturing.