ABSTRACT

These efforts have been implemented over the past three to four decades and have not been successful in controlling healthcare costs, improving quality, or increasing access.

The Affordable Care Act (ACA) took a different approach. Although its name implies a serious effort to reduce costs, its primary goal is to increase access to care by incentivizing states to increase the number of people eligible for Medicaid, offering subsidies so that people can purchase insurance through state and federal exchanges, and requiring everyone to have health insurance or pay a fine. The goal of increasing access is laudable, but if the ACA does not bend the cost curve lower, how much will this expanded access cost? Can the present system, which is experiencing a physician shortage, cope with higher demand?