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Colleagues share thoughts on the June Supreme Court decision
e-Reports, July 23, 2012
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Physicians’ opinions about last month’s Supreme Court ruling on the Patient Protection and Affordable Care Act (ACA) are as diverse as that of the country’s population. Some agree, some disagree – but most all have some concerns. And there’s wide agreement that health care delivery in the U.S. is on the verge of sweeping change – no matter the actions in Washington, D.C.

ISMA Reports gathered a sampling of opinions from your physician colleagues around the state to share with readers.*

“As with any large piece of legislation, there are good and bad things about the ACA. As a family physician, however, I see the ACA as a net gain for my community. Enhanced wellness coverage, access to health care regardless of pre-existing conditions, extended coverage for college-aged young adults, and insurance premium controls through national mandatory cost-sharing all help to shift the focus from expensive subspecialty care to cost-effective evidence-based preventive care.

“As the regulations of the ACA blend with the payment model of ACOs (accountable care organizations), Americans should expect growing pains, but these will mature into a health care system that rewards patients and doctors who focus on getting well and staying well.”

Jason E. Marker, M.D., M.P.A.


“I think the PPACA takes a nuclear weapon to a system that needs to be fixed by a precise scalpel. Millions more patients will be thrown into the already underfunded Medicaid pools. Health care by necessity will be inevitably rationed, doctors will flee, small businesses will suffer and subsequently, so shall the economy at large. Quality and timeliness will plummet. CMS already has too much authority, and this will only make it worse.”

A. Brooks Parker, M.D.

Family Medicine, Anderson

“I’m glad there is better clarity with regard to what is law and what is not. I remain concerned with regard to practically adapting to the legislated local, regional and national health care system changes.

“I am concerned with how our state’s citizens and businesses will respond to the law in the context of how it will influence their personal and group health care choices. I also am concerned with how our local and state communities will respond to take care of the uninsured patients who are not well included in any system of care.”

David C. Rau, M.D.


Mary Baker, M.D.
Mary Baker, M.D.

“I was thrilled to read the Supreme Court’s decision regarding the ACA. I believe the legislation, while not perfect, is a strong step in the right direction to correct a broken system that fails my patients every day. However, despite the Supreme Court’s decision, the debate about health insurance is far from settled. At least the groundwork has been laid so we may move forward in a meaningful way to improve health care and insurance coverage in this country.

“In terms of the impact, I am not an economist, but my hope is that more people will become insured. This will allow more primary care visits and decrease the use of the ED as a primary care clinic. The other hope is that with more coverage, we can initiate treatment earlier and avoid late and devastating presentations of disease, which are often incredibly costly.”

“The intrusion of government into every aspect of patient care can only result in elimination of the doctor-patient relationship. Socialized medicine delivers terrible care and terrible results at unaffordable and unsustainable cost to individuals and to society. The latest health care legislation is a classic case of fascisim at its worst, and was brought about by a corrupt federal corporatist system with the collusion of the legislature who has betrayed the oath to uphold the Constitution and represent the electorate.”

Daria Schooler, M.D.

Neurosurgery, Columbus

John McGoff, M.D.
John McGoff, M.D.

“Emergency physicians have a unique perspective on health care because they serve on the frontlines of medicine, providing the safety net for the uninsured and underinsured. A typical emergency department will have a payer mix with demographics of 50 percent Medicare/Medicaid and 25 percent self-pay. They can tell you all about the woes of the present system with rampant cost shifting, long wait times, ED patient holding, ambulance diversion – to name a few.

“Visits to the emergency department have been increasing steadily over the last decade. With passage of PPACA, most anticipate even greater growth. Expansion of Medicaid roles does not necessarily equate with access to health care. There is a growing shortage of primary care doctors and many who do not wish to increase their Medicaid population.

“Thus, while these patients may now have an insurance card, their only point to access health care will continue to be the local emergency department.”

Don Wagoneer, M.D.
Don J. Wagoner, M.D.

 “I am concerned that those of us who own our own practices and offer a large array of ancillary services will be forced to join a hospital ACO (accountable care organization) or some other large organization that will the impact our practice immensely, both professionally and financially.

“As a small business owner, what appears to be a large financial burden from health care costs will impact us adversely.”

* ISMA Reports staff requested reaction from numerous members around the state; what appears here are those responses received by presstime.

Here’s a tool to help you understand coming changes

The Physicians Foundation, a nonprofit organization that works to sustain medical practices and support the patient/physician relationship, has a comprehensive report examining the provisions of the Patient Protection and Affordable Care Act (ACA). “A Roadmap for Physicians to Health Care Reform” focuses on the major legislative changes that hold the most significance to the daily practice of medicine.

Find the report here.

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