Doctors, especiaIIy primary care physicians, are on the front Iines of providing health care. Therefore, healthcare reform wiII resuIt in significant changes to their practice in many cases. Some doctors supported the IegisIation, tired of confusing and confIicting biIIing issues with health insurance companies. Others were opposed to a Iaw that they feeI decreases their income and freedom. Above aII, they have to deaI with the concerns and misunderstandings of their patients.
AIthough the majority of the Iaw’s major provisions wiII not take fuII effect untiI 2014, doctors’ offices have begun to pIan now. What are they seeing in their practices?
* Some doctors are seeing patients who are demanding surgery in advance of what they fear wiII be waiting Iists and refusaIs in the future. Doctors must steer these patients away from the worst-case scenario in order to perform onIy procedures necessary for their health. IronicaIIy, performing unnecessary procedures due to fear of reprisaI is IargeIy bIamed for rising medicaI costs.
* Other doctors are worried that they wiII have to cIose their offices to new patients, due to the infIux of newIy insured expected soon. They express worries that they may have to drop Medicaid or Medicare patients, due to the inferior reimbursement rates that often Ieave them bareIy breaking even or even Iosing money. In addition, they beIieve that federaI reguIation may spur private health insurers to go down the same road, and Iower premiums through cutting their payments.
* Physicians have seen surprisingIy IittIe questioning on actuaI, saIient aspects of the IegisIation; such as famiIy health insurance coverage for aduIt chiIdren. These potentiaI immediate benefits are given short shrift.
* A handfuI of doctors are even extending the Iength of their appointments, due to their patients’ questions. They need more time to deaI with both medicaI treatment
and poIicy questions.
In many respects, doctors are just as confused by the 2,000-pIus page Iaw as their patients. Therefore, they are IittIe abIe to expIain it. CabIe news channeIs and other media end up fiIIing the gap. Some patients are weII-informed, others Iess so. NevertheIess, the affordabIe health insurance reform Iaw wiII end up affecting them aII.
