COMMENTARY

Understanding What the ACA Means for Ophthalmology

American Academy of Ophthalmology 2013

Roger F. Steinert, MD; Nancey K. McCann; Brock K. Bakewell, MD

Disclosures

November 22, 2013

In This Article

Next Stop: Single Payer?

Dr. Steinert: It has been said that this is actually a straw man and that the people who designed this designed it to fail, because when it fails it will push us into single payer.

Ms. McCann: Single payer. I knew you were going to say that.

Dr. Steinert: Is it that far-fetched? It is hard to see how this could go in any other direction if it does not work the way it is structured, and you just pointed out at least the potential for it not working.

Dr. Bakewell: We are talking just about the ACA, and certain premiums are going up for patients who had minimal policies before, which they didn't have to pay as much for. Now they have to pay more because of what is mandated by the ACA. There are more requirements now on the insurance companies. They can't deny coverage for preexisting conditions.

Ms. McCann: That's a good thing.

Dr. Bakewell: Yes, that is a good thing. That is one of the good things that the law did, but it is going to cost the insurance companies more money when they can't limit how much money they are going to pay for someone's disease entity. If the patient gets cancer, they can't just stop paying the patient's breast cancer treatment, so the insurance companies are going to be laying out more money. Yes, they are going to have more people coming to them and they are going to collect more premiums from those, because they are going to have higher enrollments, but they are also going to be laying out a lot of money. My concern is that if they have to lay out too much money, then our private insurance companies are going to go belly-up and we are going to be pushed into a single-payer system with the federal government. That is my concern.

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