The Obama Plan – An Orthopedic Surgeons Point of View

Late last night, the House of Representatives passed HR 3962 by a vote of 220 to 215.  Very close. One Republican jumped ship and a huge debate over federally funded abortion was resolved to carry the vote.

From an orthopedic surgeons point of view, there are a few good things about this bill.  There are provisions which promote a state grant for medical liability alternatives.  There are provisions eliminating the antitrust exemption for health insurance and liability insurance companies.  There are no provisions for a punitive Physician Quality Reporting Initiative.  Finally, there are no provisions for Independent Medicare Advisory Council where Congress would abdicate its reposonsibility for Medicare policy.

These are the good things.  But there are many things of great concern for those of us who remain thoughtful about health care reform.

HR 3962 calls for the formation of a new advisory body, similar to the CMS Innovation Center proposed by the Senate.  This body lacks input from physicians.  There will be no regulatory agency accountability either.

There will be a redistirbution of residency slots with the sole focus on primary care.

There will be restrictions on physician owned hospitals.

There will be the establishment of a public national medical device registry which lacks privacy protection for physician level data.

Finally, there needs to be a permanent repeal and replacement of the Medicare Sustainable Growth Rate formula.

HR 3961, the “companion bill”, takes these major factors into account.  The provisions within this bill will allow health care reform to succeed by creating a stable Medicare program on which our elderly patients can rely.  If we allow these current flaws to continue, health care reform will be in trouble.  We all know our current system is in trouble. But like surgery, we can’t stop after the diseased organ is removed, we still have to finish the operation until the patient is closed up and successfully awake in the recovery room.

Apologies for a very serious blog but major changes are coming and we are all in a position to influence how health care will be delivered to us in the coming generations.