The Patient Protection and Affordable Care Act: Is it good or bad for oncology?

摘要

In a recent funny and telling segment on the Jimmy Kimmel Live show broadcast on October 1, 2013 entitled "Six of One: ObamaCare vs. The Affordable Care Act," people were asked about their preference for ObamaCare and the Patient Protection and Affordable Care Act (ACA). Most believed that these were 2 different health care programs, and had strong preferences for or against one or the other, likely based on ideologic convictions rather than an understanding of the provisions of the ACA. When asked about details, nearly all the respondents favored the components of the ACA while still objecting to "ObamaCare." As the ACA is implemented, controversy continues to surround it, with strongly held opinions existing regarding its eventual effect on health care in the United States. Depending on the wording of questions, surveys have demonstrated that 40% to 60% of Americans remain opposed to it because they are either convinced that it offers too little or too much. Despite the strong opinions, there are significant gaps in the understanding of what the ACA provides or stands for. Reviewing the premises of the ACA may help to clarify its potential impact on our health care. We, the authors of this article, come from 2 states at the opposite ends of the health care spectrum: Massachusetts and Texas. The potential future of the ACA may be glimpsed through an assessment of the smaller-scale 2006 Massachusetts health care insurance reform law implemented by Governor Mitt Romney in April 2006. As a result of this law, citizens of Massachusetts now have affordable health insurance, with 99% of its residents covered. Approximately two-thirds of the state's adults say they support the reform. The program has tangible humane and economic benefits. It improves access to care. It increases people's ability to get jobs and children's ability to learn. It improves lives, provides peace of mind and economic security to families, increases productivity for large and small employers and for students, and (the bottom line) saves lives. It also creates jobs and contributes to the economic health of the state.