Paul Fronstin has published a great analysis of the Patient Protection and Affordable Care Act of 2010 (PPACA) health insurance exchange provisions in a new brief distributed by the Employee Benefit Research Institute (EBRI).
Fronstin suggests that the PPACA exchange system could lead to a return to the idea of creating an employer-sponsored defined contribution health benefits system, in which employers give the employees a set amount of cash and tell the employees to go buy their own guaranteed-issue, mostly community-rated coverage through the exchanges.
Some of the challenges would be worker satisfaction with group health coverage, group purchasing efficiencies, worker health literacy, and the role of the employer in defending workers against insurers.
I think what Fronstin leaves out, and what all the many polite people who respect the hard, stressful work that doctors do to save lives leave out, is that, at least when it comes to billing, many doctors' offices see a high-cost procedure in every checkup.
