It looks as though Thursday, June 28, 2012, will be the last day of the current term of the Supreme Court of the United States (SCOTUS). Look for the Court to issue an opinion on the Affordable Care Act (ACA) by that day.
The biggest debate at the moment surrounds the so-called “individual mandate” that requires everyone to purchase some form of health insurance. The Supreme Court could throw out the controversial individual mandate but allow other portions of the statute to remain. Just how important is the individual mandate? It depends on who you listen to on the mandate issue. Opponents of the ACA have been arguing that without the individual mandate, the ACA shouldn’t survive. Conversely, ACA supporters are downplaying the mandate’s importance, focusing instead on the expanded healthcare coverage they assert was the intent of the legislation.
Can the United States achieve healthcare reform without the mandate? It’s impossible to know, but as we await the SCOTUS ruling, political spin is in overdrive on both sides of the Congressional aisle. Regardless of the SCOTUS ruling, there can be no debate that we need to do something to slow out-of-control healthcare spending in this country. Mechanisms must be put into place to determine the clinical value of the tools, tests, and procedures we use in the delivery of healthcare. To truly improve health outcomes while controlling costs, we need to get off the “more is better” merry-go-round and embrace comparative effectiveness reviews.