Written by Shirley Jay   

Intro: This series of articles attempts to explain how Obamacare will affect the average American experiencing the delivery of health care. Guest specialists will be featured from time to time. The Inside Story of America's New Health-Care Law and What It Means for Us All is used for quoting the ACA. The Kaiser Family Foundation web site (kff.org) supplies most of the statistics, since it gathers information from governmental sites and brings them together in an organized form. Other sources of information come from numerous medical, nursing, government and health websites. Comments and opinions are from my 40 years' experience in the health field as well as my hobby as a health historian. All quotes and paraphrasing are credited to the original sources.
These articles WILL NOT DISCUSS THE PERSONAL FINANCIAL ASPECTS OF ACA since the costs are based on many contingencies. In general the richer will pay more, the poorer less or none at all.. State by state, exchange by exchange service prices seem to change daily. Each state has its own websites attempting to explain details and each individual should research their own health insurance choices.
IN A NUTSHELL
The Affordable Care Act or Obamacare is creating the greatest revolution in health care in America since Medicare. Changes are happening quickly, not so quickly and slowly but they are happening and there's no going back. New innovations and health service units are being created as I write. The ACA encourages these new methods. Using the carrot of grants and the stick of fines, the bill is directed toward the long term improvement of health care for all Americans by fixing the broken health delivery system. The ACA rewards health service providers and hospitals for quality care and good outcomes, while withholding, fining and limiting payments for poor performances.
Aiming to "improve quality" and "increase value" the ACA promotes greater coordination between doctors, nurses, caregivers, hospitals, and insurance companies by merging them into one entity. It is relying on healthcare information technology to limit care options by ensuring adherence to "evidence-based care;" and encouraging institutions to give care in settings outside of the hospital in cheaper settings cared for by ancillary skilled providers. These are goals the healthcare industry has had for ages but the ACA codifies them turning these aspirations into the law of the land.

By moving the health care system away from a focus on treating sickness and disease to a system that promotes wellness and prevention public health will be greatly improved with a more economical system.
CONTRADICTIONS
America's medicine is the envy of the world. We have the best hospitals, the most highly trained, most skillful and innovative doctors in the world. Our scientists produce the majority of the most significant advances in biomedical research. We spend over 3 trillion dollars or 17% of our gross national product on health care"".more than any other nation in the world! Yet our life expectancy ranks 31st in the world behind Japan, Iceland, Costa Rica and Spain. ".. and 37th in infant morality behind Croatia, Cypress and Cuba according to the World Health Organization. Clearly only a privileged few get to benefit from our best in the world health care!! Plus the congressional budget office predicted that absent drastic changes our health care costs would swell to 25% of the economy by 2025 and keep rising from there. Our U.S. Census Bureau states that 45 million Americans have no medical coverage at all. Meanwhile those of us who have coverage have seen our private insurance rise yearly. Say goodbye to the worst health care system in the world and hello to the Affordable Care Act and our complicated but much improved future!
The old system was never planned or systematically created. It just evolved from a mish mash of various practices that somehow got globbed together. Doctors, who for years were the Gods of medicine had all the power in the delivery of health care. They ran the hospitals and created the system to best serve their needs. Usually this was to the detriment of their patients and to other health personnel and it fostered and allowed a multitude of sins. There was no standardization and practices from state to state and hospital to hospital varied enormously.
Then in the late 80s and 90s the corporations began getting into health care and ran them as profit making businesses which only made things worst and worser.
In 2010 when the Affordable Care Act (ACA) was passed, the system as practiced was outdated, wasteful, illogical, unregulated, confusing, cumbersome, expensive, prone to error and economically unsustainable. Despite what the American Hospital Association and others tried to do, the system stubbornly resisted monitoring of care and drastic self improvements. While some hospitals like Kaiser tried out new innovations to improved health services most of the old guard and their lobbying professional group the American Medical Association (AMA) considered this a power grab and resisted all change. Now the ACA has created a new system. A monitored system with the power to move the old guard, kicking and screaming, into a new, modern healthier, if more regulated environment.
Our new system is a vibrant, living, growing turning and twisting mass of services with millions of participants, givers and receivers stretching toward the almost impossible dream of quality health care for all. It has a thousand dark pits of errors, mistakes, glitches and greedy devils lurking in the shadows willing to let their fellow humans suffer and die to make political points or to amass their fortunes of filthy lucre. But our new system also has its mountains of miracles"..where cures and new treatments offer hope and comfort to the afflicted""brought to the masses by a mighty dedicated army of Healers devoting their lives to the shining goddess of Health whose blessings enrich all the citizens of our noble country. Knowing that there will always be failures, missteps and challenges, as well as glorious rewards, this massive army of Healers accepts and continues this quest for health now made possible by the world altering legislation known at the Affordable Care Act.