Now that it appears that the Patient Protection and Affordable Care Act (PPACA) will move forward and become implemented gradually over the next few years; it is paramount that we look at the long term consequences of the act.

One of the major provisions of the PPACA is that insurance companies must provide free screenings and preventive testing to all of their policy holders.  Now everyone knows that there is no free lunch, so these “free” items provided to the policy holder are charged to every policy holder through higher insurance premiums.  It is the same ploy used by other retailers.

President Obama's re-election to the White House will likely accelerate plans to comply with the Patient Protection and Affordable Care Act (PPACA). Tuesday's win for Obama will likely unleash a “torrent of rules that have been withheld until after the election," states David Merrit, managing director of intelligence business firm, Leavitt Partners.   For example, payers can expect to see regulations for federal exchanges, guaranteed issues, rating limitations and community ratings, maybe even by the end of this week, Merritt noted.

As the entire healthcare industry is undergoing major reforms, maybe it is time that we look at updating one of the foundations of healthcare.  The Hippocratic Oath has been is existence for centuries as an ideal on which a physician’s ethics has been based. 

Even though everyone has heard of the Hippocratic Oath, there are very few physicians, let alone lay people, who have actually read it or know what it contains.  For instance, the Hippocratic Oath doesn’t actually contain its most quoted part: “first do no harm.”

The answer is “Yes”, depending on how the question is worded, or who you are asking.  There are so many variables concerning the Patient Protection and Affordable Care Act (PPACA or ACA) that no one really knows the answer to this question.  But, you can provide your own answer to the question, based on the following assumptions:

 

An estimated 10-15 million new Americans will qualify for Medicaid due to the passage of the ACA

 

The ACA will cut the Federal deficit by $500 billion

 

Who do you think will have to pickup the tab?  Now, personally, I don’t believe any of the figures that are bandied about by either side when it comes to the actual dollar amount that the ACA will cost or save to implement.  The truth is that no one knows how it will shake out.  But, just relying on past history, the government projections have consistently vastly underestimated the cost of any social program.

The Patient Protection and Affordable Care Act of 2011 (PPACA or ACA) will have a dramatic affect on every insurance company in America.  How these changes will ultimately affect Americans and healthcare providers will depend on how insurance companies adapt to meet all the requirements of the ACA while they attempt to remain profitable.

Let’s be perfectly clear on one item:  The purpose of the ACA is to force insurance companies out of business, so that the only option available for Americans is to depend on the government to provide healthcare insurance.  Get ready for Medicare/Medicaid type coverage for patients and reimbursement levels for healthcare providers.

Americans hate to be told what to do!  How many times has a patient walked into your office and told you that they saw a commercial on TV and they want a specific drug?  Or they self-diagnosed themselves on the internet and they just need a referral.  Even owning your own practice you can’t get away from being told what to do.  And we play nice until it is time to not play nice.  After all, you are the one with the medical degree, if you could get a doctorate on Google for $19.95 every 19 year old in their parents basement would be treating cancer.  

Now imagine that the government created the Kool-Aid Committee.  And this committee’s only purpose was to make the American public drink one glass of grape Kool-Aid every day.  Would you drink the Kool-Aid?  Sounds harmless right?

Well the government has already created the Kool-Aid Committee  It is called Mandatory Health Insurance.  It requires every American to have health insurance “if they can afford it” or they will be provided a voucher if they cannot.  It also requires employers with over 50 employees to offer insurance.

The Obama administration made a major concession last week when it announced that it was scrapping the long term care program known as ‘Community Living Assistance Services and Supports’ (Class).  Kathleen Sebelius, the secretary of Health and Human Services (HHS) said that she had concluded that premiums would be so high that few healthy people would sign up. The program, which was intended for people with chronic illnesses or severe disabilities, was championed by Senator Edward Kennedy before his death.

Every day we grow closer to the full implementation of the Patient Protection and Affordable Care Act (PPACA), which becomes fully enforcable by 2014. This is, conveniently, long after the general elections of 2012 and the politicians who brought this legislation on the American public are safely insulated from their votes on the bill by the short term memory of American voters.  However, the effects of the legislation are already taking its toll on the American public, their health care, and the economy in general.  I came across several articles recently, which highlight some of the concerns that the opponents of the PPACA have voiced over the past year, since its passage.

In this era when concepts such as "transparency in healthcare" or "informed consumers" are used often, some are saying that too much patient information leads to poor decisions by patients or their families.  How much information should you provide to your patients so that you comply with your legal obligations, while allowing your patients to make an informed decision?  The bare minimum of information that you should give your patients is that which is required by your state to meet the legal ‘informed consent’ standard.  Do you need to provide any more information than this?

One of the ways that the Patient Protection and Affordable Care Act (PPACA) aims to reduce Medicare/Medicaid expenses is to utilize Accountable Care Organizations (ACO). An ACO is a group of doctors and hospitals that will share the responsibility for providing quality care to patients. Under the new law, an ACO would agree to manage all of the healthcare needs of a minimum of 5,000 Medicare recipients for a minimum of three years.