Dr.Reeces’s Pieces, May 5, Six Positives and Six Negatives of Health Reform Bill

Key words – 32 million insured, pre-existing conditions, adult children coverage, lifetime caps, Donut hole, runaway costs, SGR, Opting out of Medicare and Medicaid, tort reform, physician shortage, physician access crisis

I see six positives and six negatives to the recently passed health reform bill. As with all contentious issues, it’s just six of one and half-dozen of the other.

Positives

The six positives are:

1) 32 million more Americans will be insured.

2) Patients with pr-existing coverage will be covered.

3) Adult children can stay on patients’ policies until 26.

4) Arbitrary lifetime(coverage) caps will go away.

5) The Medicare Part D “donut hole” will be closed over ten years.

6) The bill provides a ten year framework for testing, changing, and even reversing its various provisions.


Negatives

The six negatives are:

1) Given past government performance and politic timidity to cut Medicare costs and to offend senior voters , its costs are likely to explode.

2) It fails to fix the Sustainable Growth Rate (SGR) formula, which calls for a 21% cut in physicians Medicare reimbursement, scheduled to take effect on June 1.

3) It fails to address the growing problem of physicians opting out of Medicare and Medicaid, which will surely take place when its provisions are implemented for cutting physician payments, rationalizing, and rationing care

4) It fails to tackle the problem of tort reform, which, according to the OMB, cuts the system $54 billion, and many times more, if one factors in the practice of defensive medicine.

5) It fails to acknowledge head-on the problem of a growing physician shortage, not only in primary care but in specialties like general surgery, nor does it offer funding to stimulate more medical students or residency slots in primary care.

6) It fails to offer solutions or funding to address the looming physician access crisis: Who is going to care for those 32 million newly insured and for those 78 million baby boomers, who will begin enter the Medicare ranks at the rate of 13,000 a day in 2011.