Cost Containment and the Patient Protection and Affordable Care Act

Abstract

The legislation " puts into place virtually every cost-control reform proposed by physicians, economists, and health policy experts. " -Peter Orszag and Ezekiel Emanuel 1 "The job of figuring how to cover uninsured people used up all the political oxygen that was available. They didn't have the energy for costs." -Alan Sager 2 For decades, the U.S. health care system has grappled with two key problems — inadequate access to coverage and increasingly unaf-fordable health care costs. Paradoxically, the U.S. spends far more of its gross domestic product (GDP) on health care than do other eco-nomically-advanced democracies, yet provides health care insurance to fewer of its citizens. 3 During the debate that led to the enactment of the Patient Pro-tection and Affordable Care Act, public officials recognized the need to address the problems of both access and cost, but in the end, the Act does far more about increasing access than it does about cutting