I’m spending an intellectually exhilarating–yet a little exhausting!–week with 19 other Implementation Research Institute Fellows in my first year out of two years of training in the state of the art in implementation science. I’m trying to figure out which strategies will be most effective in making sure that evidence-based practices for treating Veteran patients with mental health disorders are actually delivered to them.
But the question all 20 of us really should be asking is–how can we effectively implement a health care system that discriminates against NO ONE in this country? Our good friends in the United Kingdom, Germany, Canada, the Netherlands, France, Sweden, Finland and more live this dream of ours. We know that no health care system is perfect–although Sweden seems to be close–but what is immensely clear is that the United States is down there, among the worst.
We’ve taken a break from our 14 hour daily training schedule to watch CNN for 30 minutes. There was a collective GASP, silence, as the reporters first stated the individual mandate was struck down, and then a CHEER, as the reporter then said, No, the Roberts Court states that the INDIVIDUAL MANDATE COULD BE UPHELD UNDER A TAXING CLAUSE.
Dada, my dear, late grandfather in India, I long to know what you would say about the constitutionality of the Patient Protection and Affordable Care Act. And more than anything, I wish you could have met Ben. Then you would realize, despite any views on ACA, why I and others fight so hard for our voices to be heard in this debate.
Update from my brother who works at the Department of Justice, from the SCOTUS Blog:
“The bottom line: the entire ACA is upheld, with the exception that the federal government’s power to terminate states’ Medicaid funds is narrowly read”.
We’ll be talking more about Medicaid later!
