The health care law’s unexpected perk

Donald J. Palmisano Former President, American Medical Association
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The passage of the Patient Protection and Affordable Care Act has already resulted in a number of tangible changes in the United States. Unfortunately, most of these changes will hurt patients. This was predicted by those who saw the bill for what it was all along: a severely flawed piece of legislation that failed to protect patients’ rights.

But a positive effect of the health care reform law is the sudden influx of professional physicians who are now running for Congress. These doctors — vying for congressional seats from Iowa to New York — have been inspired by the urgent need to address the many harms that the health care law caused to America’s health care system, along with the lingering problems it failed to address.

If these doctors are elected, they will have their hands full trying to fix it.

Two of the central promises made to the American people about health care reform already have been broken.

First, we were promised overall health care costs would drop. They have risen considerably and are predicted to continue skyward. A recent report from chief actuary of the Centers for Medicare and Medicaid Services said that the new healthcare reform law would result in price hikes for seniors with Medicare Advantage — their plans will cost them almost $600 dollars more by 2017.

And we were promised that no patients who like their health care insurance or their doctor would have to change. But already tens of thousands of Americans are being forced to make these changes to their personal health care. Among those are thousands of non-union Boeing employees who were recently informed that the cost of their health care would rise as a result of the health care bill.

“The newly enacted health care reform legislation, while intended to expand access to care for millions of uninsured Americans, is also adding cost pressure as requirements of the new law are phased in over the next several years,” wrote Boeing’s senior vice president of human resources in a letter to non-union workers who were upset that they were being unfairly targeted.

Additionally thousands of senior citizens who rely on Medicare Advantage for their health care needs will lose their coverage altogether, and with $500 billion in cuts coming Medicare’s way, only time will tell the coming horrors for American seniors.

Furthermore, in a clear admission by the Obama administration that its health care bill is failing, the federal government was forced to issue waivers to 30 of the nation’s largest employers so they could continue to provide health benefits to their employees.

Future members of Congress will also have to finally provide a permanent fix to Medicare’s payment formula to ensure patients get the care they so desperately need. The current formula has become so outdated that it’s forcing physicians to stop serving Medicare recipients altogether.

Congress should restore liberty by allowing patients and physicians to agree on any amount not covered by government or private insurers’ price-fixing fee formulas. Australia does this with its version of Medicare.

And putting millions more people on the failed Medicaid system is a cruel hoax. Having an insurance card that the majority of physicians won’t accept because the payment is less than the cost of delivering care is not increasing access.

Legislators also ignored medical malpractice reform in the health care bill. Because this process is badly broken, doctors have no choice but to practice defensive medicine — adding unnecessary costs and stress to patients. Our health care system needs to be patient-focused, not lawyer-focused, and needs to help keep doctors in the operating room and out of the courtroom.

I have always thought that good doctors often can make good lawmakers, as we are concerned listeners, taught to calmly think out complicated problems and then to act decisively while carrying out our decisions.

Maybe an increased number of doctors joining the legislative process on Capitol Hill would be just the prescription necessary to help provide Americans the kind of health care reform they deserved all along.

Repealing the health care bill and replacing it with sound, effective, patient-centered policy would certainly be a start.

Donald J. Palmisano, MD, JD, FACS, a former President of the A.M.A, is spokesman for the Coalition to Protect Patients’ Rights, a group of more than 10,000 physicians dedicated to improving the quality and availability of healthcare for all Americans. He is a clinical professor of surgery and clinical professor of medical jurisprudence at Tulane University School of Medicine.