A Medtech Industry Veteran’s Take on the Affordable Care Act and Health Insurance Exchange Enrollment

It is said that “all politics is local.” Similarly, all medical care is personal. The fundamental relationship in medical care is between the patient and physician. This has been forgotten in the national effort to extend healthcare security to all Americans. The main flaw in the national insurance enrollment effort, aside from the technical problems of the Web site, is that it basically links patients with insurance companies, not with doctors or accessible patient treatment centers.

Far better would be an effort to engage physicians and affiliated hospitals and clinics to sign up patients, as is currently done for Medicare and Medicaid patients, and for prospective patients to find out what local medical services providers will best meet their needs. Financial incentives and penalties can still be implemented to obtain as much voluntary participation as possible. But Americans will have to take on more personal responsibility for their healthcare.

Future success will also depend on state governments’ willing cooperation. Medical and insurance licensing programs are already within the jurisdiction of each individual state. Statewide health-insurance programs, where implemented, have largely been successful and have met with little opposition. It would be far better given the current infrastructure for healthcare to be administered by state authorities rather than the federal government. Stating the premise another way: It is for the federal government to mandate affordable healthcare with the states having the responsibilities of administering. The main problem of course would still be funding. The particular bugbears of state and local governments are unfunded mandates. Perhaps the federal government can augment state resources with tax and other revenue collections that can be apportioned to the states based on a per capita distribution.

The American people must also be convinced that paying the necessary taxes, fees, and other impositions will be worthwhile. Programs to educate and convince the electorate that healthcare is to be accessible without concern of cost to the patient—as is the norm in every other industrially developed country—must be implemented. As much as possible, these programs should be sourced locally and deal with specific local healthcare issuers and policies.

As has been expressed in previous articles and op-ed pieces, the medical device and diagnostic industry has a vested economic interest in making the Affordable Care Act (ACA) a success. More patients with more knowledge of their responsibilities for their own well-being will lead to more uses of medical devices and diagnostic technologies. There will also be additional growth not only from increased use of prophylactic and preventative measures, but also from the use of medical devices in therapy.

As currently drawn up, the ACA obviously has many flaws. Particularly preeminent—in addition to the national enrollment scheme—is the medical device tax. But extending healthcare security to all Americans is a desirable goal, and simply because there have been problems with the initial efforts to obtain this security, this does not mean that such goals should be abandoned. The United States and its people can weather these initial missteps much as they have done in the past, beginning with abandonment of the unworkable Articles of Confederation and replacing it with the constitutional government we have today.

Jeffrey R. Ellis, Ph.D., MBA has more than 30 years of experience in the design and manufacturing of medical devices and has written many technical articles. Hisprevious research in medical devices includesdeveloping materials for IV-fluid administration systems and evaluating compatibility of materials with medical formulations and sterilization procedures. His most recent work in medical device research is in evaluating the need for antimicrobial technologies to prevent hospital acquired infections. He has recently been very active in evaluating regulatory impositions and policies and determining whether such impositions are justified and helping clients develop strategies for getting such impositions rescinded.