The U.S. Supreme Court is expected to rule as early as today on the constitutionality of the Affordable Care Act. The decision on President Obama's signature legislative accomplishment comes a little more than four months before the November election.
This tip sheet offers University of Virginia experts who can comment on the issue and the court's ruling from a variety of standpoints.
Health Care Reform
• Dr. Arthur "Tim" Garson Jr.
University Professor of Public Health Sciences; director, Center for Health Policy; former U.Va. provost; former dean of the U.Va. School of Medicine
A leading expert on national health policy, Garson has authored or co-authored eight books, including, "Health Care Half-Truths: Too Many Myths, Not Enough Reality." He has served on two White House panels and on several national task forces on improving the health care system. He has strong views on health care reform; for instance, he argues that roughly one-third of total spending in the American health care system – about $700 billion annually – is wasted.
"Tax breaks will clearly help reduce the uninsured," Garson says. "The key is, how much is the break? It's no good if anyone has to come up with more than 5 percent of their income, or if they buy 'insurance' that when you read the fine print actually barely covers a doctor visit and no tests. More than seven in 10 people who are uninsured work – and continue to work – and so the ability to be covered between jobs is vital. Automobile accidents don't just occur when people are working."
He co-authored a provocative paper, "Reducing Obesity: Strategies from the Tobacco Wars," suggesting that taxing unhealthy foods would curb their consumption.
Garson and colleague Carolyn Engelhard co-author a monthly health care column for The Houston Chronicle outlining myths and realities of American health care. Previous columns:
Previously, Garson and Engelhard co-authored a similar monthly health care column for Governing Magazine.
Engelhard, co-author of "Health Care Half Truths: Too Many Myths, Not Enough Reality" on the challenges and politics of health care reform, excels at breaking down the complex issues involved. Engelhard and Arthur Garson co-author a monthly health care column for The Houston Chronicle. Previously, they co-authored a monthly health care column for Governing Magazine.
• Dorrie Fontaine
Dean of the Nursing School and Sadie Heath Cabaniss Professor of Nursing
Associate dean of the Frank Batten School of Leadership and Public Policy
Fontaine is able offer her perspective about the case, changes to health care in light of the decision, and would reiterate that, no matter what the Supreme Court decides, dramatic changes in nursing will continue their pace.
Dean of the U.Va. School of Nursing since 2008, she is a long-time intensive care nurse and a critical care nursing professor.
"Nursing is changing at lightning speed, and the Supreme Court's ultimate decision about health care reform won't stop that," Fontaine said. "Fewer primary care docs, a sicker patient population, changes in the parameters surrounding nurses' scope of practice (the ability to prescribe, diagnose and treat) and a mandate for higher education all mean that the depth and breadth of a nurse's job is more complex than ever."
Patashnik's current major research project explores the politics of evidence-based medicine and how politics shapes the quality of health care decisions in the U.S., including analysis of American public opinion on the Obama administration's push for evidence-based medicine, funded by two major national grants.
He argues that the health care reform battle will continue, no matter how the Supreme Court rules.
His public policy research has focused on the interaction of institutions, agendas and interest groups in the development of major legislation, including Social Security, Medicare and Medicaid. His most recent book is "Living Legislation: Durability, Change, and the Politics of American Lawmaking." His 2008 book, "Reforms at Risk: What Happens After Major Policy Changes Are Enacted," received the Louis Brownlow Book Award given by the National Academy of Public Administration.
Will the health care reform law last after 2010 election? (Christian Science Monitor / April 6, 2010)
An economist with expertise in strategy and innovation, Teisberg focuses her current research on innovation in health care. She is co-author of the book "Redefining Health Care," which addresses the paradox of why competition doesn't currently work in health care and how to make it work.
"The problem with our health care system isn't that we have too much or too little competition, but that we have the wrong kind of competition," Teisberg says. "The structure of health care delivery has to change. Consumer-driven health care won't work."
Teisberg is also a strong proponent of universal health care coverage – "Not just for reasons of ethics," she says, "but for reasons of economy as well."
Guest column: Rethinking the role of employers (Financial Times / July 3, 2008)
Health Care Reform, Individual Mandate, Health Care Marketplace
Riley, who also has a secondary appointment in the Department of Public Health Sciences at U.Va.'s School of Medicine, teaches food and drug law, health law, animal law, bioethics, regulation of clinical research and public health law.
She says, "Health reform is a likely flashpoint in the rhetoric and debate leading up to the election in November. And there are many uncertainties, the most important of which is probably the expected ruling this summer by the Supreme Court on the individual mandate and Medicaid expansion. But the election may also provide opportunities to explain the legislation comprehensively to the American public in ways that have been elusive up until now. The ACA is very complex legislation – but the health care marketplace is very complex. It affects everyone and is a major engine in the economy. Everyone involved in health care agrees that reform has been necessary. The difference is in the details."
Support for embryonic stem-cell study drops (Richmond Times-Dispatch / Dec. 15, 2006)
• Richard Bonnie
Bonnie is one of the country's foremost experts on health law policy and has written or commented extensively on health care reform in the media. He is a member of the Institute of Medicine of the National Academies and chair of Virginia's Commission on Mental Health Law Reform, which has spearheaded major reforms in the wake of the Virginia Tech shooting. (Bonnie in the Media)
• Thomas Hafemeister
Hafemeister is an associate professor at the School of Law and the School of Medicine. He teaches courses in medical malpractice and health care quality, bioethics and the law, mental health law, and psychiatry and criminal law, and has published articles on a range of issues where law and health intersect. (Hafemeister in the Media)