OPINION July 28, 2013, 6:34 p.m. ET
The Affordable Care Act's Rate-Setting Won't Work
Experience tells me the Independent Payment Advisory Board will fail.

By HOWARD DEAN
Continuing efforts by congressional Republicans to "defund" further implementation of the Patient Protection and Affordable Care Act, even if it takes shutting down the federal government, are willfully destructive. As Sen. Richard Burr (R., N.C.) told the press last week, "I think it's the dumbest idea I've ever heard . . . as long as Barack Obama is president the Affordable Care Act is gonna be law."

Clearly, the foremost achievement of President Obama's first term is the Affordable Care Act, and when fully implemented the law will move America closer to universal health coverage—something many progressives have sought for years. Like it or not, the law—at least its foundation—is here to stay, and lawmakers ought to focus over the next year on ensuring a relatively smooth implementation.

Although I've been critical of many components of the law, there is still much to applaud. Accountable Care Organizations could eliminate duplicative services and prevent medical errors while seeking to reduce costs for individuals, particularly if their creation ultimately leads to the end of fee-for-service medicine, as I believe it will. In addition, the Health Insurance Marketplace exchange systems, once implemented, will provide individuals with competitive plan options based on price, services, quality and other factors. Even more important, the exchanges will make the process of securing health insurance much easier and more transparent for millions who don't currently have it.

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