|By John Dorschner, The Miami Herald|
|McClatchy-Tribune Information Services|
"We are at a critical time in health policy," said
"Bumps may be understating what we may go through," said
They spoke at the conference on the Business of Healthcare Post-Election. The speakers accepted the federal reforms -- often referred to as Obamacare -- as not only inevitable but necessary. As Tom Daschele, a former Democratic U.S. senator from
But the reform act, signed into law in 2010, contains more than 2,000 pages, plus thousands of pages more of enabling regulations -- details that will have major, and perhaps unexpected, impacts on the healthcare industry, which now makes up almost 20 percent of the nation's economy.
In October, insurance exchanges will open for enrollment -- groups that will allow individuals and small businesses to purchase policies with no exclusions for pre-existing conditions. Starting next January, virtually everyone will be required to have insurance,
"The one thing we know is that healthcare reform will be reformed," said
The provision will mean huge increases in the policies of younger persons, to pay for the much higher costs of their elders. Insurers are asking for that policy to be postponed for two years, retaining the present maximum spread of about five to one, so that younger people could sign up for insurance without huge sticker shock.
For example, if a 25-year-old pays
The thinking of lawmakers was that by lowering ratio, the costs of healthcare would be spread out and shared more equally by the population.
That brought an objection from UM President
Shalala also noted that the law is designed to help people who now have "lousy insurance," with such high deductibles or other limits that the people tend to avoid healthcare.
Many speakers noted that the law makes only small steps toward controlling healthcare costs. All agreed that cost containment is necessary to keep healthcare from overwhelming the economy. But that could be difficult.
But a 1997 act sought to limit
"The quickest way to clear a room on
The reform act attempts to reduce cots by creating accountable care organizations, in which groups would join together for coordinated care that many believe would reduce duplicated services and reduce costs. This ACO trend means that many hospitals and other groups are consolidating to form larger organizations.
Summing up one panel discussion,
NOTE: An earlier version of this story misspelled the name of
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