Obama's Spin on Health Insurance Misses Key Points

Greg A. Hood, MD

Disclosures

March 14, 2014

In This Article

What Does the ACA Mean for Doctors? Key Challenges Remain

Over the next 6 months there are 3 major hurdles to face that are likely to have a dramatic impact on the healthcare system, as well as on the American public's opinion of healthcare delivery reform as voters prepare to head to the ballot box again this November.

1. The Sustainable Growth Rate (SGR) deadline comes again, April 1, with a 24% cut promised to physician payments, a cut that primary care practices cannot endure. The SGR legislation has been a cancer growing on the back of medicine for 11 years. That's 11 years, 16 patches, and $154 billion in waste, not counting the impact on workforce planning and other secondary effects.

Currently there is a bipartisan, bicameral solution ready to be voted on (H.R. 4015/S. 2000). Furthermore, a discussion of the ACA is a timely venue for addressing this, as these bills simplify and unify existing Medicare quality reporting/incentive programs and allow for a more rapid and robust expansion of evidence-based delivery models throughout Medicare, consistent with ACA goals.

2. In the WebMD interview, one of the questions posed was that Americans are "troubled by the limited number of doctors and hospitals that they're finding take their insurance. How do we get more doctors and hospitals participating in these plans?" The reality is, we don't. They don't exist. They aren't in the training pipeline, because Congress and the Obama administration have refused to fix and fund the inescapable bottleneck in the training pipeline.[1] Furthermore, my region of the country has seen an unprecedented wave of physician retirements among primary care physicians, further magnifying the workforce shortfall.

3. In speaking about the flawed Obamacare Website, President Obama referred to "the terrible experience back in October and early November." The administration, including Health and Human Services Secretary Kathleen Sebelius, has been inflexible about the onerous and tedious unfunded mandate in 6 months to convert all diagnosis coding to ICD-10. If the currently anticipated problems of testing, systems verification, and interoperability sound similar to the problems from the failed ACA site rollout, they should. Implementation costs have been estimated to be in the range of $5-15 billion, most of which comes as an unfunded mandate upon providers (physicians and facilities).[2]

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