Regarding Mark J. Tyler’s Nov. 11 column, “Paperwork over outcomes”:

Dr. Tyler makes assertions about the Affordable Care Act belied by the facts. He contends that none of the Republican opposition’s ideas were included in the act. In fact, the provisions of the act were initially put forth by the conservative Heritage Foundation. If progressives had their way, a public option would be part of health care reform. It was compromise with the Republicans that resulted in a program benefiting the insurance industry.

The reform act moves medical providers to focus on the outcomes, not the process, as Tyler contends. The law begins the framework to pay providers based on the medical outcomes they achieve for patients. This is a change from the current system of paying for every procedure ordered. This is going to result in substantial savings in health care costs.

The law does not establish a new, larger federal bureaucracy. Health care coverage will continue to be administered by existing bureaucracies and insurance companies.

I like Tyler’s idea to use the Medicaid system to eventually expand coverage to all. Actually, this could have been the public option that progressives gave up in order to compromise with Republicans.

I am sorry that Tyler does not believe the best days for health care are ahead. The fact that affordable and preventive health care is on the horizon for millions who have gone without tells me just the opposite.

Marcia Swift

Cedar Rapids