Any of the positive things being said about the Affordable Care Act get lost in the media cyle over the din of the detractors shouting about doom and gloom. They call it a giant government takeover of free enterprise, rant about the IRS getting access to medical records, tell us that grandma is being thrown under the bus so that the “welfare queens” can have a Cadillac insurance plan at the expense of Medicare and the taxpayer, etc.
While the much maligned exchanges with the admitted start-up pains will only directly affect about 10% of us, the remaining 90% are already covered by insurance through their employer or government programs such as Medicare, the reforms which the law has put in place have the potential to affect nearly all of us.
Sam Glick who follows the reforms for the Oliver Wyman Consulting firm says, “This is the 90 percent of the story that doesn’t make the headlines.”
Since the law was passed, there have been more than 370 new and innovative medical practices started in the country with another 150 being organized now. They are known as accountable care organizations and operate in a whole new way.
They do not use the old paradigm where the doctor was rewarded for multiple and extended hospital stays, surgeries and ER visits. Instead they are rewarded financially by both private insurers and Medicare for preventive practices which also translate to better outcomes and longer, healthier lives for their patients.
These organizations have been compared to the Silicon Valley start ups at the dawn of the information age, driving inventiveness and entrepreneurial energy.
What these new organizations are doing in no way resembles the old way of doing things in medicine. Instead of treating disease, they are treating patients in an effort to keep them healthy and extend their lives as well as improving the quality of life.
One such group of 250 Doctors in North Carolina, Cornerstone Health Care, has a program in which patients with a history of congestive heart failure, are called once a day and asked to weigh themselves since weight changes can be predictive of imminent problems. The plan is to eventually give each of these patients his own scale which will connect through the internet to the organization’s computers and automatically record the weight of the patient, alerting staff to any potential problems.
They also offer low cost pedicures to diabetes patients because ingrown toenails are often the cause of infections leading to amputation.
Another network in California offers Medicare patients free dance lessons, healthy cooking classes and casino excursions with “brain power” activities on the bus, while a new practice with 7 doctors in Buffalo, NY is building a new gym for their patients.
While none of this has the glamor of the heroic surgeon who valiantly battles to save the life of a patient, it does reduce the overall costs and give to the patient a better quality of life.
“There are organizations that are bringing emergency room visits down by 15 to 20 percent,” Glick said. “Hospital admissions, you see numbers like 20 and 30 percent. That can make a huge difference not only in the cost of care but also in the quality of care.”
Big business is starting to sit up and take notice of the effects of this new approach to health care. Walgreens and CVS are beginning to partner with hospitals and accountable care organizations to provide their employees with easy access to better methods of treatment.
Even Walmart, one of the most vilified employers in the nation, has begun a program which will fly workers to the best possible location for the treatment that they need in the case of major procedures.
Many states are also changing the laws so that well qualified professionals such as nurse practitioners, pharmacists, EMTs, and physicians assistants are allowed to provide services that they are currently forbidden to do.
While physicians lobbying groups continue to resist many of these changes, individual doctors seem to have little objection to it. With as many as 29 million new patients, there will be plenty of work to go around.
One reason that we have heard so little about the bulk of the law is that it is so complicated. There is however a book available written by Stephen M. Davidson of Boston University which can be a helpful guide. But one may be forgiven for thinking that the main objection to it from the right may have its roots in a deep seated hatred for its main proponent, President Obama.
