Healthcare Reform 102
Healthcare Reform: What Does it Mean For Doctors and Patients?
Questions, conflict and debate surround the controversial Healthcare Reform Act (HRA) or the “Patient Protection and Affordable Care Act”. One of the biggest questions, with no clear answer is, “How will it affect patient care?”.
Two prominent groups, the American Medical Association and the American Nurses Association are strong advocates of HRA. Notes AMA President J. James Rohack, M.D., “The pending bill isn’t perfect, but we can’t let the perfect be the enemy of the good.” The ANA advocates healthcare reform, while recognizing that the debate is not yet over. Other groups supporting the HRA include the American Academy of Family Physicians, the American Hospital Association and the American Chiropractic Association.
Publicly, the ANA states that the law will increase access to care for millions and will strengthen and improve the healthcare system for generations to come. Privately, many doctors and nurses have a much different view.
According to a survey conducted on behalf of the Physicians Foundation, 75% of physicians polled said they would take steps to change their current practice style in the next 1-3 years. Many will seek retirement, or get out of the health care practice entirely. When asked in the survey if they would be able to take care of more patients, the majority responded with no, stating that they are already at their limit.
In a 2011 National Physicians Survey of nearly 3000 physicians from 50 states 65% surveyed believe the quality of healthcare will deteriorate over the next five years. Their reimbursement from Medicaid will continually decrease (this year by 25%). As a result many physicians polled are expecting to seek early retirement or better opportunities, leaving the majority of patient care to Nurse Practitioners and Physicians Assistants. 75% believe their reimbursement will be less fair under HRA.
A Different Form of Health Care?
While the intent of the law was to get more people covered with insurance, the outcome may not be quite what was expected. Fewer physicians will see more patients for less reimbursement. At Evanston Regional Hospital, CEO George Winn says no one is sure what to expect. He feels healthcare quality will continue to improve in Evanston, but also realizes that the hospital faces a trade-off, as they will be seeing an increase in patient load for less money.
Dr. Mike Adams feels it is important to give patients a sense of responsibility when it comes to their health. He feels the government would be most helpful by empowering individuals to make wise choices for their health through education. His concern is that patients will have high expectations for others to fix their problems resulting in less personal responsibility.
The President of the American Association of Neurological Surgeons, Troy M. Tippet M.D. stated, “Physicians know first hand that our health care system needs reform - but the current Senate health care bill is ‘bad medicine’ for patients”.
The need for healthcare is clear. The answer is unclear and at best convoluted. With the number of physicians steadily decreasing over the last decade, and projected to worsen over the next ten years, and patient numbers steadily increasing, a perfect storm is forming over healthcare in America.
Comparing Physicians Assistant and Nurse Practitioner
Masters or Doctorate Degree
Licensed through state medical board
Focus on preventing, maintaining and treating human illness
Conduct physical exams, diagnose & treat illness, order and interpret tests, assist in surgery, write prescriptions
Practice medicine with a supervising physician
Masters or Doctorate Degree
Licensed through state nursing board
Focus on prevention, wellness, patient education
Treat both physical and mental conditions: comprehensive history taking, physical exams, physical therapy, and ordering tests and therapies
Can serve as primary health care provider
Certified in an area of specialty (women’s health, pediatrics, acute care, etc.)
Importance of Nurse Practitioners
With this summers Supreme Court decision, regarding Health Care, and the re-election of President Obama to a second term, the Affordable Care Act will become a part of our lives.
The Supreme Court ruled only on the constitutionality of the act. They refrained from commenting on the feasibility of it. That portion of the act will be lived out by each one of us, as states begin the lengthy and expensive process of starting Insurance Co-ops. While the federal government has given states the option of creating their own co-op or using a federally constructed model, many questions remain. Many states are concerned about the cost of creating such an insurance co-op, while others are struggling to maintain their Medicaid programs, which are proposed to increase under the Affordable Care Act.
With a fiscal cliff looming, and congress locked in disagreement, the Affordable Care Act might be something that we just can't afford.
Taking Responsibility For Your Health
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