It has been over six months since new Obamacare rules have affected private practices in Medicine. From my standpoint, this as not been a good thing for patients. Sure, it is laudible and appropriate that every American should have affordable access to health care. But at what price? Patients are already being herded into groups that will have to answer to “ACO’s”, accountable care organizations. Just a new word for HMO’s that require layers upon layers of administrative permission to get the care that is needed accomplished. Who benefits? Corporate America, and Insurance companies, which profit acting as “the middle man”. This happens whenever administration and regulations become more complicated, and too difficult to follow. Soon, it will all be about corporate profits and bonuses paid for with-holding necessary care. While I do see the potential for abuse in a “fee for service” world, at least in that system, patients do get the care they need. In the post Obamacare world, patients will be convinced that surgery is a bad thing ( because momentarily is seems more expensive to payors), and physical therapy and pain medication will be a better option. The truth is, well performed joint replacement surgery is extremely cost efficient when measured in the years of increased economic productivity the recipients enjoy. Imagine the “cost savings” of taking a 50 year old “disabled” man or woman, who has bilateral knee replacement, and who then rejoins the workforce.
Think also of the mental health gains! Already insurance company stock prices are at all time highs. Do you think that is because more premium dollars are going to the care of patients? No, its because they can keep more of it as bonuses for executives. Pharmaceutical companies are at all time highs as well, because Obamacare did nothing to help decrease the ridiculous cost of medications. The exact same drugs used here in the USA cost much more than they do around the world. How does that make sense? This new system is not better, and soon patients will realize that their “access to care”, and their ability to get procedures done will be made more difficult. I do have patients from Canada and Mexico who travel to Scottsdale to get joint replacements done on a timely basis, because the national health services in their countries make them wait in pain for years!
Medicare has come out with so many new requirements and administrative paperwork, that most smaller private practices will need to close or fold into a large corporate backed ACO. This is why I have chosen to opt out of some plans, so I can continue to take the very best care of my patients. I will likely see less numbers of patients in the future, but those who can stick with the Scottsdale Joint Center will benefit from the best orthopedic surgical care available in the world!