By David W. Anderson
The U.S. Supreme Court again upheld a crucial part of the Affordable Care Act by ruling that subsidies to help low- and moderate-income Americans purchase health insurance are legal.
New Yorkers who receive subsidies to purchase health insurance on the New York State of Health marketplace were never at risk. This court case challenged the authority of the government to provide subsidies in the states that did not establish their own health insurance exchanges.
To date, more than 408,000 New Yorkers have purchased coverage through the marketplace, 74 percent of them qualifying for a subsidy.
While getting people covered remains a critically important goal, another point of the law was to improve the quality of care and address underlying costs of health care to stabilize premiums. Much work needs to be done to make health care more affordable.
The cost of health care services continues to rise. Health care affordability is not only a major concern for families, it is a major concern among New York employers.
Health care for most Americans is still too fragmented and uncoordinated, often duplicative and wasteful, leading to uneven quality. The nation pays a huge price for these inefficiencies. Estimates are that Americans annually pay $700 billion for more care, rather than better care. Reduced emergency room visits alone could save $21 billion annually. We also spend $4 billion annually on overused prescriptions.
Achieving higher quality health care while controlling costs is possible, but it requires significant changes. We must focus on preventing illness instead of reacting to it – rewarding doctors and hospitals for quality outcomes instead of volume, and enhancing technology so health professionals and insurers work together to provide the best and the right care.
At BlueCross BlueShield of Western New York we are partnering with our members, doctors and hospitals to transform the health care system to provide better coordinated, quality care that helps patients stay healthy, get healthy and prevent illness and chronic conditions.
We have partnered with Kaleida Health and Optimum Physician Alliance to better manage patients with diabetes, improve care for patients at high risk for congestive heart failure and get pediatric asthma patients into care earlier. We have worked for years with employers to design worksite wellness programs to support members in making positive health changes. And we fund innovative models like outpatient knee procedures that allow patients go straight to recovery and rehabilitation, avoiding hospitalization.
These are the true outcomes of successful health care reform.
David W. Anderson is president and CEO of BlueCross BlueShield of Western New York.