With the deadline for open enrollment just over a week away, a collection of the most prominent health-care leaders in Santa Barbara spoke to hundreds about the Affordable Care Act (ACA) in the packed Fess Parker Ronald Reagan Room on Tuesday evening. Several panelists agreed that uncertainties pose the largest challenge facing providers, but those challenges also open the door for new leadership and creative collaboration.
Interest in the confusing topic was evident by the sheer number of attendees. Despite various unknowns about how the reform act will play out, several panelists said the fact that the health-care system had been largely ineffective — fragmented and “provider-centered” — gives hope that a transition toward “patient-centered” care for all is possible.
Perhaps the first audience question best demonstrated muddled public understanding of the new law: Is the Affordable Care Act the first step toward the single-payer system? “I’d like to phone a friend,” responded Sansum Clinic CEO Kurt Ransohoff, eliciting a laugh from the crowd. He then said he doubted the “cynical view” that the act was intentionally flawed to ensure it would eventually fall apart. But the future of the ACA, he added, is just not clear yet. Such lack of clarity is even evident with ambiguous information and unusual patient behavior. Sansum saw an uptake of patients last November and December — rather than during January and February, typical flu season — because people were eager to meet their deductibles at the end of the year given the indefinite future. Further, despite that an individual mandate is a component of the ACA, the modest fine for ignoring it is an unlikely incentive to ensure people sign up.
Another change was addressed by Visiting Nurse & Hospice Care CEO Lynda Tanner, who said 40 percent of the home health-care agencies will have to close, hindering quality of care to people in rural areas. In closing remarks, Sansum Clinic’s Dr. Fred Kass explained that missing from the entire Affordable Care Act discussion are representatives from the pharmaceutical industry. “There’s an assumption that if the pharmaceutical companies don’t make a certain profit, it will stunt the growth of new medicines … We’ve got to find a way to control the cost of pharmaceutical drugs.”