La Obamacare y el gobierno eficaz

BERKELEY – Cuando los historiadores recuerden la Ley de protección de los pacientes y cuidado de la salud a bajo precio (ACA, por sus siglas en inglés), la polémica reforma de la atención de salud lograda por el Presidente Barack Obama en 2010, prevemos que no prestarán demasiada atención a sus reglamentos, las dificultades que entrañaron las substituciones de seguros antiguos por otros nuevos o el defectuoso lanzamiento de su sitio web. En cambio, pensamos que se centrarán en cómo fomentó la Obamacare una oleada de innovación que puso coto gradualmente al vertiginoso aumento de los costos de un sistema disfuncional, al tiempo que millones de americanos, antes excluidos, obtuvieron el acceso a los seguros médicos.

La innovación es probablemente el aspecto menos comentado de la reforma de la atención de salud. Sin embargo, reviste una importancia decisiva para corregir la curva de los costos de ese sector, porque permite la prestación de una atención de salud de calidad y asequible. La Obamacare ha brindado nuevos y fuertes incentivos para dicha innovación.

De 1980 a 2010, el gasto en atención de salud de los Estados Unidos aumentó casi el doble que la economía, al pasar del 9,2 por ciento al 17,4 por ciento del PIB. Si bien muchos factores contribuyeron a ese tremendo incremento, la mayoría de los expertos convienen en que la causa más importante fue un sistema de pago por servicio que resultaba tanto más provechoso a los prestadores de atención de salud cuanto más servicios cobraran, en lugar de por mantener sanas a las personas y tratar sus enfermedades eficientemente.

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