The pharmaceutical industry dodged a huge bullet with the Supreme Court’s decision to uphold the Affordable Care Act. The upfront deal the industry made that was the financial foundation for the entire act will stay in place and allow some degree of predictability for the industry over the coming years. More people will be brought into the system, and although they may not be able to afford the more expensive products, they also might. The most heartening part of the decision was that the Chief Justice went nonpolitical and in many ways preserved the dignity of the court and his legacy as the head of the highest court in the land.
One of the most important features of the bill for those of us with insurance is that it takes away the handcuffs so many have to their employers. The number one concern people have when they are laid off is what to do about insurance. How much Cobra time do they have and the expense often overwhelms future career choices. People stay in jobs they hate because they need insurance for the family especially if the spouse does not have an employer who offers it. Those that want to start a business or who would rather work part time while raising kids or getting near retirement can’t do it because they are tied to the insurance. People work for other people rather than for themselves because of the fear of not being able to get insurance.
With the affirmation of the ACA and it’s full implementation in 2014, people will be given a huge degree of freedom. Employers will continue to offer insurance as, like a salary, it is a benefit that allows them to compete for talent. Those that want to go on their own can merely recognize this is a cost they will bear and not have to worry about pre-existing conditions and being charged unaffordable fees by the insurers. It is interesting to take a step back and look at the genesis for employer paid health insurance. It started when, because of wage controls during WWII, employers couldn’t steal the limited number of available workers from other companies. To get around the problem, they began to offer and pay for healthcare insurance. What started as a huge upside for the worker has over time become the number one reason people remain locked in situations they dislike and in many cases work for less money than they are capable of earning in other places.
There are many people who do not like the ACA and will talk about complete repeal and starting over in Congress. I argued earlier this week that it is important to really look at the facts and get away from the politics. Each of the parts of the act need to be examined and if there are parts people don’t like then perhaps try to legislate change there but not on everything. I for one don’t like the fact that we have to pay for it, but it is the right thing to do. When you do tear it apart, the polls are overwhelmingly positive towards each of the pieces. Let’s build from there and once again continue to develop the greatest healthcare system in the world.
Take a look at this recent Gallup poll that shows that confidence in the healthcare system has been improving since we started to debate the reform and has continued to increase ever since the law was passed. Note that Republicans have always had a better view of the system then Independents or Democrats, but now everyone’s opinion is changing for the better. We have a long way to go but today’s ruling allows us to move forward and not go back to the things we hated before the reform was even being discussed.
What is the immediate challenge for marketers in our industry? Now that it appears the ACA is reality, it is time for those who doubted it would be implemented to figure out how to do what the early movers have been doing for a couple years. If there was any doubt about Affordable Care Organizations, both government and commercial, it is time to catch up. Pricing ideas and salesforce alignments now need to consider the implications of the reform. The relative importance of PCPs, NPs and PAs based on their critical role in the implementation need to be considered. These are incredibly exciting times for the industry and we should take great pride in the leadership role we took to actually get the financial parts of the discussion going. Now let’s continue to show the leadership in the total implementation and watch how those who move first and fastest become the new leaders in our industry.