News Columns & Blogs

Verdict on health law to take time

In March, Congress passed and the president signed into law, the Affordable Care Act, which puts in place comprehensive health insurance reforms that will hold insurance companies more accountable, lower health care costs, guarantee more health care choices and enhance the quality of health care for all Americans.

Whether you get health benefits through work, buy insurance yourself, are on Medicare, do not have insurance or have a small business and want to provide health coverage to your employees, the Affordable Care Act gives you better control of your decisions about health coverage

Once the plan is fully implemented, the law is supposed to give Americans access to affordable coverage. To help lower costs, the Affordable Care Act:

n Establishes a new competitive private health insurance market, through state exchanges, giving millions of Americans and small businesses access to affordable coverage, and the same choices of insurance that members of Congress will have.

n Holds insurance companies accountable by keeping premiums down and preventing many types of insurance industry abuses and denials of care, and ending denial of coverage against Americans with pre-existing conditions.

n Puts the federal budget and economy on a more stable path since it is expected to reduce the deficit by more than $100 billion over the next 10 years, and by more than $1 trillion over the second decade, by cutting government overspending and reining in waste, fraud, and abuse.

In theory, I hope the law works and we will find out in five years if it did. I do see some things in the bill that concern me. The main problem with controlling healthcare costs in the United States is that a “third payer” intervenes between recipients and providers.

Do you know the full cost of your last doctor visit? Probably not. That is a serious problem. Another problem is the network. Many doctors in this area do not accept Medicare. The government payments are usually 20 percent or more lower than that of insurance providers and the cost of doing business are running some doctors out of work.

According to a survey conducted by The Medicus Firm, a nationally retained physician search firm, “nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.” The Medicus Firm queried a random sample of 2,250 physicians from their physician database, and received the responses of 1,195 doctors. Specialists accounted for 63.6 percent of responses, while 36.4 percent were primary care physicians (family practice, internal medicine or pediatrics). Eight percent said they would leave right away, even if they were nowhere close to retirement age.

The Affordable Care Act brings much to the table when talking about pros and cons. We have a law in place that is expected to lower health care cost and provide all Americans with affordable coverage. However, we also have a law that still does not communicate the direct cost to patients, doctors and hospitals when it comes to service because of third party administrators and paperwork. We also have seemed to put a higher hurdle for those in the medical profession. The plan is for five years until it is up and running. It is at that time we will know if it is successful.

Mike Miele, with MGA Financial Insurance Group in Lakewood Ranch, can be reached at (941) 907-3828.