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article imageCosts and efficiencies of Affordable Care Act in question Special

By Michael Krebs     Mar 29, 2013 in Politics
A new study revealed a 32 percent increase in costs under the Affordable Care Act, and the question of treatment efficiency versus costs remains an uncertainty.
The Affordable Care Act championed by President Obama and his Democratic allies in congress is continuing to demonstrate price increases among health insurers, according to a new study, and concerns remain that - as the legislation rolls out over the course of the next few years - its costs may impact efficiencies in treatment.
The new study found that healthcare claims will increase by as much as 32 percent, as CBS News reported on Wednesday. According to the Society of Actuaries report, healthcare claims will jump notably as sicker people join the coverage pools.
"Claims cost is the most important driver of health care premiums," Kristi Bohn, an actuary who helped publish the research, told CBS News.
The Affordable Care Act presents questions on efficiency, as Joan Tryzelaar, MD, FACS, FACCP shared in a recent interview with Digital Journal.
"This is a very interesting question because nobody really knows yet how the Affordable Care Act is going to affect treatment," Tryzelaar said. "Funny enough in Maine, where I live, there was an OpEd in the newspaper that suggests that when the act is enacted approximately 70,000 Mainers who presently don't have insurance will now become eligible for insurance, and that the economic benefits include such things as the creation of 3,000 new jobs. Now, if we take that in the perspective of providing adequate cardiology treatments, you need to know that approximately 70 percent of the stenting procedures that are done in this country are done on patients who have what is called 'stable coronary artery disease.' That is a situation where a patient has blockages in his coronary arteries but where his symptoms are relatively controlled with medications. Many studies have shown that stenting in those patients who have coronary artery disease but with symptoms that are controlled offers no benefit over what is called 'optimal medical therapy.' Optimal medical therapy includes medications to control the angina symptoms that these patients may have, and it also involves modifications of lifestyle."
According to Dr. Tryzelaar, when these lifestyle modifications are instituted, they "have proven to be at least as effective at a fraction of the cost of what I would call the indiscriminate use of stenting procedures in patients who could be managed with lifestyle modifications."
U.S. Health and Human Services Secretary Kathleen Sebelius admitted to reporters on Tuesday that the Affordable Care Act's costs will not be fully known until the end of the year, as Reuters reported.
"Everything is speculation. I think there's likely to be some shifting in the markets," Sebelius said.
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