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#ACA Thoughts

We invited people across our region to share their thoughts, hopes, and observations about ACA implementation. Our commentators bring a diversity of perspectives, from frontline to leadership, from health care to policy.


We invited people across our region to share their thoughts, hopes, and observations about ACA implementation. Our commentators bring a diversity of perspectives, from frontline to leadership, from health care to policy.

Russell Duke

Russell Duke

Director, Idaho Central District Health Department

Until our country has the political will to shift resources away from paying for health care to investing in keeping people well in a meaningful way, costs have nowhere to go but up. I am hopeful that as a state our policy makers will identify a solution for our low-income, uninsured individuals and families so they can purchase affordable health insurance and gain access to a patient-centered medical home. As a country, I would like to see the health care system quickly evolve into one that is truly incentivized for keeping people healthy.

Vicki Dundas

Vicki Dundas

Nursing Supervisor, Missoula City-County Health Department

I‘ve been a registered nurse for 29 years, and I've seen the toll our health care “system” has taken on families and children. An uninsured family whose child has been diagnosed with cancer can easily emerge from the ordeal with over a million dollars in debt. And that‘s not counting the emotional and physical toll on everyone in the family. Families shouldn‘t need to have bake sales to cover the cost of their child's illness in America in 2014, nor should they be ruined financially the rest of their lives! I'm glad the ACA provides insurance to people who previously could not afford it or were ineligible. This will be a cost savings for the country in the long run.

David Fleming

David Fleming

Director and Health Officer, Public Health - Seattle & King County

What‘s so important about the Affordable Care Act is that it’s providing coverage to people we need to reach—low-income adults who often face poorer health, fueled by the social conditions that influence it. From a public health perspective, it’s exciting to have this momentum and opportunity to make significant headway in improving these conditions in affected communities, and in turn improving people’s health. We can do this by linking health and human services in a customer-centered framework that emphasizes prevention and addresses the larger community forces at work, such as education, employment and the built environment, in creating good health.

Laurie Jinkins

Representative Laurie Jinkins

27th Legislative District, Washington State House of Representatives

It’s our job as legislators to make the ACA work. When I first ran for office, my then 10-year-old son told me that health care should be my number-one priority because too many people were worried about losing their health care. He was right. Now that people have access, we need to focus on cost control. The health care industry is one of the biggest on earth. And it gets to drive demand for its own products. We need to help bring down the cost of care. We need to incentivize quality care with good results, not incentivize expensive procedures.

Will Pittz

Will Pittz

Executive Director Washington CAN!

I am most concerned about affordability. Will low-income working people be able to afford premiums, cost sharing, and deductibles? How will this impact access and coverage for people who need health care? Despite the ACA, advocacy for health care reform remains as important as ever. Health care is still treated as a privilege and a commodity; until we recognize health care as a human right and minimize the profit motive in the system, we will always need to work for health care reform.

Jim Roberts

Jim Roberts

(Hopi), Health Policy Analyst, Northwest Portland Area Indian Health Board

The most important thing that tribal communities should understand about the ACA is that it provides an opportunity to get health coverage that will complement the services they receive from Indian Health Service (IHS). It will allow their health programs to generate resources by billing insurance carriers for such services and the revenue can be reinvested back into their health programs. This will provide more resources to provide health care to tribal members in their communities. If they don’t participate, it will simply draw down IHS funds to provide health care, with no reimbursements, and there will be fewer health services available in their community.

Dacey Storzbach

Dacey Storzbach

Incoming medical student

It seems almost certain that physicians will be asked to do more with less. This isn't necessarily a bad thing if it means creating more efficient ways of practicing medicine, but the trick will be to create efficiencies that have minimal negative consequences for patients or providers. I expect to see greater utilization of electronic medical records and telemedicine, care teams composed of multiple types of health care providers, and compensation based more on results and less on individual procedures. I don't think that a physician's job will look anything like how it's been for the last 10-15 years or so.

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