Work together to fix ACA

by Denis Knight, DO dennisknighttonededitedjan17web

With his decisive vote last month against Republican legislation repealing the Affordable Care Act, Sen. John McCain of Arizona expressed support for an approach that most Americans favor: Work together to fix the health care act, do it public and do no harm in the process.

The ACA has its share of problems, and many of them affect physicians. Despite the extreme political partisanship of late, I still believe that most Americans want congressional representatives from both parties to sit down and fix those problems in a lasting way. Most reasonable people realize that, whether it’s a successful marriage or a medical practice, discussion and compromise are essential to lasting success.

A recent poll by Kaiser Health reinforced this, with 57 percent of respondents wanting to see Republicans work with Democrats to improve the 2010 health care act. Even more Americans – nearly 4 in 5 – want the president and his administration to do what they can to make the ACA work. Less than 1 in 5 want the Trump administration to help it fail.

Physicians know well that many of their patients – many Americans – may not hold entirely realistic expectations of what the health care system can and cannot do, and how affordable it should be. But patients as well as doctors know how the cost of care and insurance affects access to the system.

Rising insurance premiums and deductibles result in patients avoiding care completely or putting off doctor’s visits until conditions become chronic or severe and costly to fix. Physicians are caught in the middle, squeezed by both low payments and the crush of paperwork. Our leaders may not know or concede it, but fixing the system is complicated. Yet the costs of not fixing it are tremendous.

But there are potential solutions that can serve both patients and the medical community. The MSSC subsidiary ProviDRs Care, for example, is working on a physician-driven, physician-developed delivery model. The value-based model is designed to improve access to care while reducing health care costs. Physicians will have access to the tools and support they need to succeed in an outcomes-based model, and be compensated for better patient outcomes. The ProviDRs Care service is intended to return control of care to the physician, which can only enhance the patient relationships that we doctors value deeply. ProviDRs Care anticipates a launch date of mid-2018.

A consistent theme from the business community is the desire for certainty. They want to know costs and regulations aren’t going to constantly change or become more burdensome. Physicians feel the same, desiring a system that has some certainty while not also asking doctors to bear an unfair share of regulations and expense.

Special interests and money from across the spectrum cloud health care matters, and often leave elected officials beholden to them instead of the Americans they serve. That makes it particularly important for physicians to make sure their voices are heard in this debate. We can regain some sense of control by staying engaged in the political process. We can monitor the various legislative proposals and share our input on what works and what doesn’t. And we can urge our lawmakers to reach across the aisle and work on changes that are sound and reasonable enough that they will survive no matter which party is in power.

By staying engaged, we will not only feel less powerless but also could end up with an accessible and affordable system that benefits patients and physicians alike.