The Affordable Care Act and the Transformation of US Health Care

  • Adam Gaffney Division of Pulmonary and Critical Care Medicine Cambridge Health Alliance Cambridge, Massachusetts
  • Howard Waitzkin Robert Wood Johnson Foundation Center for Health Policy, University of New Mexico Health Sciences Center Department of Sociology, University of New Mexico Department of Internal Medicine, University of Illinois School of Public Health, University of Puerto Rico
DOI: https://doi.org/10.5209/CRLA.53456
Keywords: the Affordable Care Act, universal models, US health care system, consumerist model of care

Abstract

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

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How to Cite
Gaffney A. y Waitzkin H. (2016). The Affordable Care Act and the Transformation of US Health Care. Cuadernos de Relaciones Laborales, 34(2), 239-261. https://doi.org/10.5209/CRLA.53456
Issue
Vol. 34 No. 2 (2016): Monográfico: La cuestión social de la sanidad
Section
Monographic

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