Preven­tion pre­vails

Wide­spread rou­tine care will help min­i­mize sever­ity of ill­ness and costs

Modern Healthcare - - OPINIONS COMMENTARY -

The U.S. Supreme Court’s his­toric de­ci­sion to up­hold the Pa­tient Pro­tec­tion and Af­ford­able Care Act pro­tects the ex­pan­sion of health­care in­surance to the unin­sured and pre­serves im­por­tant health­care im­prove­ments that will ben­e­fit count­less Amer­i­cans. The law ends in­surance com­pany de­nials be­cause of pre-ex­ist­ing con­di­tions, elim­i­nates life­time caps on in­surance and al­lows mil­lions of young adults to stay on their par­ents’ health in­surance poli­cies un­til age 26. The law’s ex­panded health­care cov­er­age will also help pa­tients ob­tain pre­ven­tive care to help avert un­nec­es­sary dis­ease and the ex­pen­sive health­care in­ter­ven­tions that of­ten ac­com­pany it.

The Amer­i­can Med­i­cal As­so­ci­a­tion sup­ported the ACA be­cause the bill re­flects key pri­or­i­ties set by the AMA’s House of Del­e­gates, which is com­posed of physi­cian mem­bers from all states and vir­tu­ally all med­i­cal spe­cial­ties. The AMA has a long-held pol­icy, set and re­in­forced by our House of Del­e­gates, in fa­vor of cov­er­ing the unin­sured so all Amer­i­cans can get the care they need when they need it and lead health­ier lives.

Com­pared with their neigh­bors who have health cov­er­age, the 50 mil­lion unin­sured Amer­i­cans live sicker and die younger. Unin­sured pa­tients of­ten put off pre­ven­tive care—the type of rou­tine physi­cian visits that keep con­di­tions from es­ca­lat­ing in sever­ity and treat­ment cost. The cost of pro­vid­ing care to the unin­sured is passed along to those who have in­surance, adding about $1,000 an­nu­ally to a fam­ily’s pre­mium. The AMA has had pol­icy sup­port­ing in­di­vid­ual re­spon­si­bil­ity since 2006, be­fore the cur­rent health re­form de­bate be­gan—pol­icy that was reaf­firmed in 2010 and 2011.

With its de­ci­sion, the Supreme Court has en­abled the unin­sured to ac­cess the cov­er­age they need to help avoid a host of un­nec­es­sary con­se­quences. Physi­cians have a strong in­ter­est in mak­ing sure all pa­tients have ac­cess to care so we can help them lead health­ier lives.

This rul­ing marks a sig­nif­i­cant step for­ward as we con­tinue to im­prove our health­care sys­tem so it works bet­ter for pa­tients and physi­cians. The Af­ford­able Care Act makes im­por­tant progress, but there is more work to be done. There are still pro­vi­sions of the law that need to be re­fined; for ex­am­ple, we sup­port elim­i­nat­ing the In­de­pen­dent Pay­ment Ad­vi­sory Board. There also are flaws in the sys­tem that pre­date the ACA and have to be ad­dressed, such as the bro­ken Medi­care physi­cian pay­ment for­mula and med­i­cal li­a­bil­ity sys­tem.

As the na­tion’s largest physi­cian or­ga­ni­za­tion, the AMA will con­tinue to work with Congress and the ad­min­is­tra­tion dur­ing the im­ple­men­ta­tion phase of the law to en­sure the best out­comes for pa­tients and physi­cians and to re­solve prob­lems not ad­dressed by the law.

Dr. Ardis Hoven is

pres­i­dent-elect of the Amer­i­can

Med­i­cal As­so­ci­a­tion.

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