Why the ACA won't solve the healthcare cost crisis

Despite some minor reductions, the Affordable Care Act (ACA) will not lower the country's healthcare costs in the long term, journalist Steven Brill argues in a new book

Brill's book, "America's Bitter Pill: Money, Politics, Backroom Deals and the Fight to Fix Our Broken Healthcare System," details how political infighting and industry lobbying made it all but impossible to pass meaningful healthcare reforms.

Despite the compromises and added layers of bureaucracy, Brill told NPR, the ACA will benefit hospitals. Currently, not only do hospitals spend vast amounts on uncompensated care, they also have to spend money on the process of collecting payment from the patients who received care.

Indeed, a major reason for the American Hospital Association's [AHA] support of the ACA was because it "created so many new paying customers for them who would now be able to pay so they wouldn't have to sue them to collect on their bills," he said. "They would now show up with insurance. So the hospitals are doing much better. The for-profit hospitals are reporting record profits as a result of [the ACA] and the nonprofit hospitals are typically, believe it or not, more profitable than the for-profit hospitals."

Despite these benefits, Brill said the reforms are not sustainable as long as healthcare prices remain much higher than they are in other developed nations where outcomes are as good or better. In the near future, "things are going to snap," he told NPR. There is still hope, he said, if the ACA forces the industry to restructure costs, but he added this would be an uphill political struggle.

Although the ACA works to contain costs, Brill told the Washington Post that addressing issues such as readmissions among Medicare patients is "kind of a drop in the bucket" compared to drug prices, tort reform and nonprofit providers' profit margins. This has been a recurring concern for Brill; his book shares a title with an article he authored in 2013 on healthcare costs in which he asserted that not-for-profit hospitals overemphasize the bottom line, which the AHA disputed, FierceHealthFinance previously reported.

To learn more:
- here's the NPR interview
- read the Post interview

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