Reform of the United States Health Care System: An Overview

University of Tokyo Journal of Law and Politics, Vol. 10, pp. 44-59 (Spring 2013)

reprinted in 2013 Ark. Law Notes

University of Arkansas Research Paper No. 14-01

17 Pages Posted: 10 Apr 2013 Last revised: 23 May 2014

See all articles by Robert B Leflar

Robert B Leflar

National Taiwan University; National Yang Ming Chiao Tung University; University of Arkansas School of Law

Date Written: April 10, 2013

Abstract

This essay, written for readers unfamiliar with the details of American health law and policy, portrays the essential features of the battle for health reform in the United States and of the law that survived the battle: the Patient Protection and Affordable Care Act (PPACA). The essay summarizes key aspects of the U.S. health care system and how it compares in terms of costs and results with other advanced nations’ systems. The political and legal conflicts leading up to and following PPACA’s enactment are described. The major features of the law, attempting to address problems of access to health care, quality, and cost, are explained. Issues remaining to be resolved in the law’s implementation are set out: the expansion of Medicaid coverage for the low-income population; the formation of each state’s health insurance exchanges; cost-control measures such as the establishment of the Independent Payment Advisory Board and the adoption of new payment models; coverage of contraceptives as part of the essential benefits package; and the role of the new Patient-Centered Outcomes Research Institute. The essay concludes that the law is poised to achieve genuine progress toward increased access to health care, but that the law’s aims of improving quality and controlling costs are far less certain of accomplishment.

Keywords: health care reform, Affordable Care Act, Medicaid coverage, insurance exchanges, contraceptive coverage, PPACA, IPAB, PCORI

JEL Classification: D78, H77, I18, K32

Suggested Citation

Leflar, Robert B, Reform of the United States Health Care System: An Overview (April 10, 2013). University of Tokyo Journal of Law and Politics, Vol. 10, pp. 44-59 (Spring 2013), reprinted in 2013 Ark. Law Notes, University of Arkansas Research Paper No. 14-01, Available at SSRN: https://ssrn.com/abstract=2247853

Robert B Leflar (Contact Author)

National Taiwan University ( email )

No.1, Sec.4, Roosevelt Road
Taipei, 10617, 10617
Taiwan
14794667406 (Phone)

National Yang Ming Chiao Tung University ( email )

Taipei
Taiwan
+886955619225 (Phone)

University of Arkansas School of Law ( email )

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United States
14794667406 (Phone)

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