A commenter recently asked what my metric for success was in terms of the Affordable Care Act. I've answered this question many times in posts and comments and one need only click here to peruse my answers over the last couple of years. In fact, I recently highlighted one such quantification that bounced off the bubble into outer space. Oh well.
Yet, unlike my conservative colleagues, I strive to be reflective. So, it is in that spirit that we start today with a new tag called "health care success." Today, I will highlight two main metrics of quantitative success that will be integral in judging the effectiveness of the ACA. As the numbers start to come in showing increased enrollment in health care insurance, we will be able to see the number of people insured in this country rise. Right now we stand at 84.6 percent insured. So, the first metric of success is to get as many of that 15.4 percent uninsured to have coverage. If we can have a total of 95 percent of the nation covered with health insurance by 2016, I'd say it was successful. That's about three quarters of that 15 percent or 30 million people. We may not be able to know this for certain until the next census (2020) but I think there will be plenty of data by the next presidential election to give us a clearer picture.
But what about that last five percent? Well, that's where my second metric comes into play. Those that don't get insurance will have to pay a fee which will offset the costs of the program. Will that fee and all the newly insured people be able to achieve the overall goal of the ACA in reducing the amount of money we spend on health care? Currently we each spend $8,233 per year and the U.S. health care costs now eat up 17.6 percent of GDP. How does that compare with other countries?
Terrible. Just terrible. This is why we had to have health care reform. Obviously, the goal here is to control growth, as I noted the other day, and the ACA is already doing that. Now we have to look at the goal numbers in terms of dollars spent per person and our GDP (adjusted for inflation, of course). A minor success would be for us to spend $8,232 per person-1 dollar less than we are now. A major one would be for us to spend as much as Norway does at $5,388 per person. I'm going to set the goal of $6,700 dollars per person which falls right in between as my measure of success. With GDP, a minor success would be to get it to 16 percent. A major success would be 11.5 percent, putting us right in the middle of many European countries. I'll set the goal here at 14 percent of GDP. \
Of course, quantifying health care success is only one piece of the puzzle. What about quality of care? We could meet these goals but what if the care level falls? In the coming months, I'll be discussing other metrics that will indicate success in terms of our new health care law. Look for the tag "health care success!"