Health Reform: Clinicians Keep Treating Patients, Regardless of Federal Laws
Dr. James Barone, a surgeon who writes under the name Skeptical Scalpel, offered this commentary on today's Supreme Court ruling upholding the Affordable Care Act.
I do not presume to speak for all clinicians. Personally, I am happy to see that medical coverage will now be extended to large numbers of previously uninsured patients although I think a single payer system would have been simplified things.
I think Dr. Westby Fisher said it best in his June 24th blog. He said that on Friday morning, “Doctors won’t care … because the day after the decision (whatever it is), doctors will still get up, go to their clinics or hospitals, wash their hands, and continue taking care of patients, whether there's a health care law, part of a health care law, or no health care law.”
I agree with Dr. Fisher. Physicians I work with have not been discussing the ACA, and I doubt most of them even know what it’s all about. Does anyone really? How many people have read all 2,700 pages? Although the accuracy of surveys can be questioned, results I’ve read indicate that 60% or more of doctors feel the new law will have an adverse affect on patient care.
Here’s what I know. According to a report on the Association of American Medical Colleges website, the new law calls for the creation of at least 46 new agencies, boards or commissions. But, the report says, “Although some observers have asserted that PPACA will result in a precise number of new boards and commissions, the exact number of new organizations and advisory bodies that will ultimately be created pursuant to the legislation is currently unknowable.”
Some doctors have asked where the money for all that is going to come from. At the very least, I suppose it will be from taxes, at worst, from a reduction in physician reimbursement. Either way, doctors will probably feel squeezed. I suspect 46 new agencies will spawn vast amounts of regulations and paperwork, already a huge burden for all of us.
It is not clear what affect the Supreme Court decision on the Medicaid portion of the ACA will have. If states choose to cover all uninsured citizens via Medicaid, hospitals will surely benefit. This fact has been noted by investors as the price of shares in hospital stocks has risen since the decision was rendered.
But due to the extremely low reimbursement rates, a large number of physicians already do not accept Medicaid or Medicare in their practices. I don’t see this new law changing things on that front.
I do know this for sure. Like most of my colleagues, I’ll be on duty at 7 a.m. tomorrow taking care of patients. Patients who are insured. Patients who have Medicare or Medicaid. And patients who have no coverage at all.
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