By William K. Alcorn
The Supreme Court’s ruling that the Affordable Care Act is constitutional was generally applauded by area health care providers.
But some have reservations, primarily about how it will be financed.
There is agreement that President Barack Obama’s health care reform will improve access to preventive and clinical care for millions of uninsured and underinsured people.
“It’s good news for people who will be able to visit doctors, utilize hospital services, and obtain preventive health care,” said David Fikse, chief executive officer of ValleyCare Health System of Ohio. ValleyCare includes Northside Medical Center in Youngstown, Trumbull Memorial Hospital in Warren, and Hillside Rehabilitation Hospital in Howland.
The 5-4 Supreme Court decision ruled that the guts of the health-care law — a mandate that individuals not covered by employer or government insurance plans buy health-insurance coverage or pay a penalty — is constitutional.
Charlene Allen of Warren, retirement security coordinator for the Mahoning Valley Organizing Collaborative, said some seniors in the community, including herself, have benefited from parts of Affordable Care Act already implemented, such as free annual health evaluations.
Allen said she received a health evaluation, which included tests that would normally cost about $1,000. And, she said, a couple of friends have been able to keep their under-26 children on their insurance.
But, Allen said, the top thing about the health reform is access to health care for people who don’t have health insurance.
The Affordable Care Act impacts the entire population, which is what public health serves, said Patricia Sweeney, health commissioner of the Mahoning County District Board of Health.
Insurance companies will not charge out-of-pocket expenses for preventive care. Often, people can’t afford to pay even the co-pay for procedures, such as a colonoscopy or PAP smear or mammogram, that can lead to early detection that can save money on overall treatment, she said.
Chronic illness is the largest cause of death in the U.S. and adds greatly to the cost of health care and impacts quality of life so dramatically. Access to preventive health care will improve outcomes, Sweeney said.
The sad part about the Supreme Court ruling is that it says states cannot be mandated to increase Medicaid coverage, she said. “That’s unfortunate because we have a significant population in Ohio that need Medicaid care,” she added.
The law, better known as Obamacare, has some positive points for physicians and patients, said Dr. Raymond S. Duffett of University Orthopaedics and one of three members in Ohio of the Board of Counselors for the American Academy of Orthopaedic Surgeons.
One, he said, is that insurance companies can’t discriminate against patients with pre-existing conditions.
But, it is not all positive, Dr. Duffett added.
One of biggest things physicians worry about is that the law will bring more government regulation into taking care of their patients.
“We are the most-regulated industry in the nation. We don’t need regulation,” Dr. Duffett said. “Individual doctors know what’s best for their patients. More government intrusion into health care will mean more intrusion into the doctor-patient relationship, especially as it relates to Medicaid, Medicare and other treatment plans.”
He is also concerned the law will raise the federal debt, and added it does nothing for medical-liability reform on the national level. It is not necessarily going to lower medical-care costs, in fact the costs probably will increase, he said.
The ability of patients to have access to medical insurance is good for any practice and its patients, said James DeCenso, practice administrator at Youngstown Orthopaedic Associates in Canfield.
“One of our big expenses is bad debt when people don’t or can’t pay for services. But the question remains: Will the Affordable Care Act reduce the expenses in health care overall ... or drive the costs up even higher?” DeCenso said.
The Ohio Hospital Association said the Supreme Court provides clarity to allow welcome and much-needed health-reform efforts already under way to move forward.
While the ruling is expected to increase demand for medical care, Ohio’s hospitals are pleased it will allow nearly one million uninsured Ohioans to obtain better access to essential care in the most appropriate setting, association officials said.
“While some provisions of the ACA merit further debate and amendment, Ohio hospitals believe leaving such refinement to future legislative action is a wise decision,” said Mike Abrams, OHA president and chief executive officer.