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July 28, 2015

From the Affordable Care Act to Affordable Care

Author Affiliations
  • 1Department of Economics, Harvard University, Cambridge, Massachusetts
JAMA. 2015;314(4):337-338. doi:10.1001/jama.2015.7683

Health reform is a process, not a destination. The Affordable Care Act (ACA) will not be the last word in health policy any more than were Medicare and Medicaid. The ACA focused primarily on extending insurance coverage. Going forward, policy will need to address 2 areas the ACA pursued less vigorously: continuing to slow the increase in health costs and improving the practice environment for physicians.

The single most important issue in health care is eliminating unnecessary medical spending. Health costs have traditionally increased at 1% to 2% annually above the growth of the economy. Long-term financial security requires the growth in cost to slow to economic growth or less. With about one-third of medical spending estimated to be wasted, achieving lower growth is technically possible.1 The question is how to make it happen.