Reading a recent article, I was struck by the commentary that healthcare leaders support the Affordable Care Act (ACA). Upon further exploration, it was not really leaders of healthcare but rather CEOs of health organizations that were dubbed with the title of leader for the purpose of the article. According to this article (and I am sure there must be other similar ones out there), these CEOs back the ACA and the move away from fee-for-service to value based care. These “leaders” are not practicing doctors. Yet, they opine why the ACA should be expanded and supported. Should we care?
The article also remarks about the GOP and Trump’s poor plan: apparently a partisan piece then. While the country’s healthcare system tanks, all politics should be removed from medicine. So, no I do not care for some partisan fixes to our healthcare system. In fact, while American lives stand in jeopardy, we need to get all politics out of medicine. Patients’ well-being is never going to be decided by pushing forth political agendas. We need real fixes based on evidence-based medicine and healthcare policy derived by good medical practices. No, I do not care who supports the POTUS’s plan for healthcare reform. As a practicing physician, I care about the health and lives of my very real patients, who may or may not vote based on Partisan lines.
Should we try to expand the ACA as what these CEOs are suggesting? It is not working for practicing doctors or for many patients. So, no, we should not try to hoist up a sinking ship. Is it working for those CEOs? Probably because by making physicians tied to value-based performance, they gain more control and power of those doctors working under them.
The MACRA law ensured that doctors will no longer be paid based upon the work they do, American capitalism be damned. Doctors shall now be paid based on metrics, much of which they have no control over. Doctors who slave away to help their sickest patients will be penalized financially because these patients are so complicated that they will never reach stellar disease metrics. Likely, these CEO’s will be clamoring to drop these patients from their rosters when they start costing them money. Do I care? Yes, because all patients deserve medical care. And all of them deserve the same quality of care. The future quality incentive model is going to guarantee the collapse of this.
What we should care about in our current healthcare system?
- Patients lives and health. And there can be no negotiation here.
- Making the system easy to navigate and understand to patients. Patients often don’t want to pay their deductible. And who can blame them when they don’t understand what a deductible is.
- Allowing access to a full spectrum of doctors. Under the ACA (sorry CEOs), the panel of doctors a patient can choose from has been greatly reduced. Patients need more choices.
- Allowing doctors the ability to practice medicine without overwhelming incumbrances. Ever try to get a prior authorization for a MRI? A patient should not have to wait weeks in pain while the insurance company plays denial games.
- Cutting healthcare costs. We all need to be on board with this but it must be done in a way that it does not sacrifice patient care, or line administrators wallets.
- Doctors and those who treat patients on the frontlines need to step up and assume the role of leaders. We are the ones who witness every day the absurdities and atrocities that medicine has become. We are the only ones who can truly fix the problems because we are the only ones who see them.
- administrators should be called to thin out their wallets and be true leaders whose minds lie in the improvement of the system and not the fattening of their wallets.
Are healthcare leaders truly standing in support of the ACA and expanding? Well, I guess that would depend on who you ask and who you label a leader. As for me, the CEO of my own practice, I say we should support a system that cares about patients. And that would not be the ACA. To repeal it with no idea how to replace would be irresponsible, We need to devise that replacement now, before the new POTUS steps in to fiddle with his own political brand of reform. Who wants to help devise the plan?
Copyright secured by Digiprove © 2016 Linda Girgis, MD, FAAFP
