Health care in America will be much better in 2020 than it is today. This was the message delivered by Ezekiel Emanuel in a lecture given in a crowded Johnson Center Cinema. Emanuel, an oncologist and former White House advisor, was also a key player in drafting the health care reform law.
“Why can I make that [claim] pretty confidently? Assuming the Supreme Court behaves rationally, all of our people will have health insurance,” Emanuel said. “They’ll have access to an exchange, and they’ll have subsidies to buy health insurance.”
The Affordable Care Act, known as Obamacare to critics of the bill, is up for review by the Supreme Court for the same reason that Emanuel cites as a major strongpoint: the mandate requiring all Americans to buy health insurance.
While the media focuses on the individual mandate, said Emanuel, a more important provision of the bill is its incentives for doctors to bundle payments. Bundling payments will allow patients to pay for an entire episode of care, such as a hip replacement, instead of paying per procedure. The Congressional Budget Office estimates that bundled payments will reduce health care costs by 10 percent.
The Recovery Act, also known as the stimulus, gave subsidies to health care providers to utilize electronic health records. The ACA takes this further by simplifying administrative processes and funding patient-outreach research, Emanuel said.
Because of these programs, Emanuel said that health care reform will save more money than estimated by the CBO, which predicted that the ACA will add $1.083 trillion to the deficit by 2016.
“If you took fresh, crisp dollar bills right out of the federal reserve, stacked them one on top of the other, $2.6 trillion would get you two thirds of the way to the moon. And we spend that every year on health care,” he said.
For some further perspective, Emanuel said, the entire gross domestic product of France is $2.56 trillion.
Emanuel was invited to give the lecture at the open session of Professor Steven Pearlstein’s Government 319 class. Pearlstein came to the university last semester as a Robinson professor.
“When I worked in the White House, everyone knew that I only leaked to two people: Steve Pearlstein and Jonathan Cohn of The New Republic,” Emanuel said. “And I never got any flack for it because everyone thought that their articles and comments were very responsive and responsible.”
Pearlstein has worked for The Washington Post for over 20 years, winning the Pulitzer Prize in 2008 for his columns on the financial crisis. Pearlstein teaches economic policy, public policy and the media at George Mason University.