When the Affordable Care Act (ACA) was passed, the Obama Administration envisioned that all states would implement the program as outlined in the law. However, unlike any federal program in recent history, 27 states have decided not to create a Health Insurance Exchange and instead let the federal government implement it at a cost in excess of $8 billion. This results in a “top down” payment system versus the “bottom up” approach the framers of the legislation expected.
What this means is that some states will have federal marketplaces, and others will have their own locally developed marketplaces for employers and patients. And because understanding the workings of this system and trying to identify and purchase a health insurance product is so complicated, the government is paying “navigators” to guide the uninsured through the maze being constructed to make health insurance more accessible. In California, for example, $673 million in federal money will be utilized to deploy 21,000 navigators to sign up people for the exchange. Reports indicate that each navigator will receive $58 for every person signed up.
How this technology will be used is another area that should be carefully monitored. The health insurance exchanges have the potential to become the largest personal database in U.S. history. Thoughtful dialogue is critical to determine how this collection of information will improve patient care.
Similarly, in our healthcare system, billions of dollars are being invested in electronic systems that collect all of our personal health information, but have brought no improvement to the delivery of quality care. They have, however, changed the way doctors and patients interact.
Now physicians are forced to spend up to half of a typical office visit hunched over a computer screen with their backs to the patient....
(Excerpt) Read more at forbes.com ...
