Regardless of who sits where in January – there will be more healthcare legislation. We already know Romney’s intention is to repeal Obamacare outright (which will require legislation), but even if President Obama is re-elected, his signature legislation, the Patient Protection and Affordability Act (ACA for short) isn’t complete – by a long shot. Some have argued that it’s legislation “around the edges” or a kind of Legislation “lite” – or simply “the best we could get” with all the sausage grinding in Washington. I tend to agree because in all of its 906 pages of glory (pdf here) – there are no tangible effects to the biggest single determinant of skyrocketing healthcare costs – pricing. To use a crude analogy, this continuing pricing saga is much bigger than the restrictive, long-term diet of the ACA – it’s the long overdue and much needed costectomy. Surgery will be required – and the “Issue Brief” released earlier today by the Deloitte Center for Health Solutions is a sobering preview of the emergency room procedure we’re headed for in 2013 – regardless of the outcome next week.
The 11 page brief (pdf here) is purely bi-partisan in that it delivers a shot across the bow to both campaigns for failing to articulate a viable path forward in our national healthcare emergency. It doesn’t, for example, specifically support the detailed proposals by 4 different groups (MedPAC, AMA, Bowles-Simpson or the Obama Administration) – only the forecast of failure. As correctly identified by Deloitte (and others) front and center in our battle of the healthcare cost bulge is the Sustainable Growth Rate (or SGR) which has, over the course of 10 years, become affectionately known as “Doc Fix.” The report gives a rich, concise and detailed overview of the history to “Doc Fix” – including this timeline graphic: