Zeke Emanuel thinks the Affordable Care Act will shrink the $2.8 trillion system to something more sustainable -- and give doctors incentive to speed up that process.
As part of the grand finale to the Washington Ideas Forum yesterday, I talked with Dr. Ezekiel Emanuel, oncologist and chair of the Department of Bioethics at the National Institutes of Health, about the implications of the Affordable Care Act. Now that the election is over, even John Boehner called it the "law of the land," and a series of important spending decisions will be made over the next few months.
James Hamblin, a trained clinician himself, wrote about the part of the conversation that dealt with end-of-life care discussions -- the dreaded "death panels" that are nothing of the kind (only a way to give patients the dignity and options they say time and again they want and need). But, as Hamblin points out, the whole subject is hard for every doctor to raise -- there's little medical-school training for a subject that's uncomfortable for everyone.
Emanuel, unsurprisingly, was optimistic that despite campaign talk, all states will opt in to the plan. Governor Rick Scott, in Florida, is already backing away from his pledge to opt out; Emanuel was confident that Governor Rick Perry will eventually participate in the Federal Medicaid expansion.