Well you don't. Neither do I, and for that matter, nor does anyone else.
Our health care system is enormously complex, so any law that is designed to reform the system also is enormously complex. The more complex something is, the harder it is to predict its results.
Yet we pretend to know for sure, without one iota of doubt, what the Patient Protection and Affordable Care Act (PPACA) will do. Supporters say that it will provide coverage to everyone, improve outcomes, lower costs, and make just about everyone happier and healthier. Opponents say it will result in rationing, bankrupt the country, and even lead to Armageddon.
Yet the honest, truthful answer is that neither side can really have all that much confidence in their assessments of the law's impact. If they were honest with themselves, and with us, they would acknowledge that there is a tremendous degree of uncertainty about how the PPACA will work in practice. Some elements of the law, like how it will provide access to health insurance coverage, can be assessed with greater confidence than, say, the long-term impact on health care costs and the federal budget deficit.
Today's online edition of the Annals of Internal Medicine, ACP's flagship peer-reviewed journal, has a commentary from me that reflects on the certitudes and uncertainties of health reform. I give my best educated assessments on the potential impact of the PPACA on providing affordable coverage to all Americans, ensuring access to primary care, and reducing health care spending and the federal debt. I also make it clear that it is not possible for me to draw definitive, irrefutable conclusions about how it will work out in the end, even though I believe that the PPACA has the potential to do great good for the country, especially when compared to the status quo. But rather than re-stating my conclusions here, I encourage you to read the article and post your comments, both here and on the Annals website.
Today's question: What is your reaction to my Annals' commentary on the impact of the new law on coverage, primary care access, and health care spending?