PPACA on March 23, 2010 the Patient

¶ … PPACA

On March 23, 2010 the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. Along with the Health Care Reconciliation Act of 2010, the PPACA became part of the overall Health Care Reform concept of 2010. The health care reform process was promoted as a way to completely transform the health care industry and ensure that all Americans received affordable health care. While supporters praise the legislation as a revolutionary law which will benefit ordinary Americans, critics claim that the Obama Administration used the health care reform process as a means of gaining control over the entire health care system. In an attempt to compare and contrast the provisions of this new law, this essay will discuss several provisions of the new health care legislation and compare the benefits as well as the criticisms of them.

Section 5501 of the PPACA provides for Medicare to pay primary care physicians, nurse practitioners, clinical nurse specialists, and physicians assistants a 10% bonus beginning in 2011. (PPACA: A Closer Look) This includes practitioners of family medicine, internal medicine, geriatric medicine and pediatric medicine "if at least 60% of their Medicare allowed charges & #8230;were for primary care services." (PPACA: A Closer Look) Supporters of the legislation assert that this will give doctors an incentive to provide primary care for Medicare patients. By providing financial incentives, this will make it possible for many primary care physicians to accept new additional Medicare patients, as well as reducing the strain on the current Medicare programs and their members. However, critics have suggested that the way the new regulations will be imposed will lead to poor service and inefficiency. The Medical Payment Advisory Commission (MedPac), a leading opponent of the new legislation, claims that the new regulations will allow physicians who are highlighted on the Medicare website as being poor performers to be rewarded with financial bonuses. (Appleby, 2011)

One of the ways that the Obama Administration plans to pay for the new health care law is by imposing a tax on large pharmaceutical companies. Starting in 2011, pharmaceutical companies will be forced to pay a new fee, based on a percentage of their sales, in order to cover the increased costs of the PPACA. "The Amount ranges from $2.5 billion in 2011 to a peak of $4.1 billion in 2018." ("Health Care Reform") The PPACA also calls for an "excise tax equal to 2.3% of the sale price on the sale of any 'taxable medical device' by the manufacturer, producer, or importer.." ("Health Care Reform") While this may seem an easy way to make large corporations to pay for the increased costs of health care services, the manufacturers, producers, and importers will most likely cover the increased costs by increasing prices for their products, thus passing the additional costs on to the consumer.

Another way that this legislation attempts to increase the number of Medicare patients that doctors will see is to form Accountable Care Organizations, ACOs. Although not scheduled to commence until 2010, these organizations would manage the health care needs of a minimum of 5000 Medicare beneficiaries for at least three years. (Gold, 2011) According to supporters, ACOs would make health care providers responsible for the health of their patients, "giving them strong incentives to cooperate and save money by avoiding unnecessary tests and procedures." (Gold, 2011) This provision is designed to create a more personal relationship between doctor and patient, but critics claim that since ACOs are paid a flat fee for each patient, regardless of the amount spent on the care of that patient, doctors will have an incentive not to provide expensive services. This could lead to doctors weighing the amount of profit they will receive against the necessity of medical testing and procedures for the patient.