By Sally Voth svoth@nvdaily.com

Three hundred guests dining at the Museum of the Shenandoah Valley Business Forum Luncheon on Tuesday had a lot to digest.

Susan Dentzer, editor-in-chief of the journal Health Affairs, spent more than an hour presenting her reasons why the Affordable Care Act was necessary, and its merits.

"It's hard to conjure up an issue in American politics that has really elicited so much divisiveness among the parties," she said. "What we might be able to agree on, however, are those things inherent in what we call the triple aim."

The triple aim is to strive for better health, better health care and lower costs, Dentzer said.

"That's it," she said. "We just have to pursue that agenda."

Individuals' health is impacted by a variety of factors, according to Dentzer's presentation. These include obesity, lack of exercise, smoking, stress and aging. There are other contributors to early death, such as genetics, social factors and a lack of health insurance.

The latter leads to the premature death of 18,000 Americans annually, Dentzer said. She said that's about half the number of women who die of breast cancer each year.

According to a RAND study from 2003, patients received recommended health care about 55 percent of the time, Dentzer said.

"Basically, it was almost a coin toss whether we get recommended care," she said. "We also have another very troubling issue, which is do we know what works in health care? More than half of the treatments that we deliver in the U.S. health care system do not have clear evidence of effectiveness. That's an awful lot of health care that is being provided without people understanding whether it works or it does not."

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Museum hosts health care reform talk