Affordable Care Act would expand coverage but does little to address fundamental flaws in health care, says UofL health affairs leader


    LOUISVILLE, Ky. – Allowing the Affordable Care Act to become law will extend the health care safety net much more broadly than is currently the case but would do little to address some fundamental problems within the U.S. health care system, says the executive vice president for health affairs at the University of Louisville.

    David L. Dunn, M.D., Ph.D., lauds the act for providing greater access to health care for a large medically underserved segment of the population. At the same time, he notes several issues with the national health care system that the act fails to address.

    The act was signed into law by President Barack Obama in 2010. Twenty-six states filed suit to challenge the act’s mandate requiring individuals to have health insurance, and the Supreme Court is expected to issue its ruling on the suit by the end of the month.

    Dunn, who joined UofL as executive vice president in July 2011, says the act’s greatest benefit is that it expands coverage to people who otherwise have little or no access to health care. “In the Commonwealth of Kentucky alone, as many as 300,000 people would become insured by the mandate,” he says.

    At the same time, he notes several problems with the act. “The less-than-optimal aspect of the ACA is that it may increase the overall cost of medical care in the U.S. because much of the care would be sought in high-cost emergency room settings,” Dunn says. “Little in the ACA deals with some of the most fundamental problems with our health care system, such as critical shortages of nurses, physicians and other health care providers, particularly in primary care. The act also does not provide greater support to the job pipelines for those health care practitioners, such as health science centers and teaching hospitals.”

    Dunn makes no predictions on how the high court will rule in the case in which the 26 plaintiffs assert that the federal government has overreached its authority. “The lawsuit centers on legal arguments, and I am a physician, not an attorney.

    “However, while states’p rights were viewed as fundamental by our founding fathers, supporting greater access to health care, promoting preventive medicine and reducing the already high national disease burden of obesity, diabetes, cancer, heart disease and more – all of which promote health and welfare for our entire nation – are laudable goals. Lawmakers should work together to chart a course to make this happen, rather than using legal arguments to block it from occurring.”

    Dunn speaks with the knowledge of 35 years’ experience in health care as an academic general and transplant surgeon and as an administrator and health care policy expert. Prior to joining UofL, he held positions in administration and on the faculty at the University of Buffalo and the University of Minnesota. He has published more than 400 articles and book chapters in the areas of surgical infectious diseases and transplantation, and his research has been funded by the NIH for 20 years. He earned bachelor’s and medical degrees from the University of Michigan and a Ph.D. from the University of Minnesota.

    Jill Scoggins is Director of Communications at UofL's Louis D. Brandeis School of Law. She has been at UofL since 2010.