Health care reform policies and implementation

Health Care Reform Recommendations

Healthcare Reforms and ObamaCare

The healthcare system in the United States is not a healthy system, but one fraught with problems which could cause a catastrophic failure. In order to prevent the collapse of the American healthcare system, for years experts have made recommendations in the hope that government officials would implement them. It was not until President Obama pushed through his healthcare bill, called the "Patient Protection and Affordable Care Act" but generally referred to as "ObamaCare," that the government attempted to implement the many various recommendations put forward by the numerous expert groups. One group of experts on the American healthcare system, the American College of Physicians (ACP), has put forward a number of recommendations that they agree would be beneficial to the overall healthcare system. An examination of Obama Care" can demonstrate to what extent the new law fulfills the recommendations of this prestigious group.

The first recommendation put forth by the American College of Physicians was that increasing "the number of primary care physicians improves quality and lowers the cost of medical care." ("ACP Issues") What is important for Primary Care physicians is control over the process of the doctor-patient relationship. As one Primary Care physician, Dr. Brian Gould, stated "as long as physicians control the determination of the 'medical necessity' of care and what is considered 'appropriate care' is community based, they will continue to be the controlling players." (Gould, 2009) It is the fear of losing control over their care of their patients that doctors fear more than a restriction of the payment they will receive, and ObamaCare leaves the important decisions in the hands of Primary Care Physicians.

The second recommendation of the ACP was for the government to reform the payment policies for Primary Care Physicians. While many point to the government control of physician reimbursement rates as a leading threat to the number of physicians who will accept new patients, this seems to be a weak excuse. The new ObamaCare legislation addresses this issue by "increasing state Medicaid payments for primary care physicians to Medicare levels in 2013 and 2014." (Nash) In other words, recognizing the issue of Primary Care Physician reimbursement payments as a major issue, the new legislation increases the payments doctors receive for Medicaid to the same levels as they get for Medicare. This will not only increase the financial security of the doctor's practice, it will also increase access to more primary care physicians to those on Medicaid.

Finally, the American College of Physicians' third recommendation was actually made in concert with a number of other professional medical organizations and called the "Patient-Centered Medical Home Model." Specifically, "a medical home is defined as a primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective." (Calvo, 2008, p. 10) Medical Homes, called "Accountable Care Organizations" in the new ObamaCare Law, will manage sick patients in a comprehensive fashion, complete with an ethics panel to avoid unnecessary and costly surgical procedures, as well as the ability to decide if plan managers have provided inadequate, or poor care to their patients. Finally, "if it is effective at saving money for a given patient/disease state, it will receive bonuses from Uncle Sam; if not, it will get less money" (Dorin, 2012) Not only does ObamaCare seem to implement the recommendation, it is doing so in an effective and economically logical manner.