From the Editor: Hope and Change
Well, it seems that Supreme Care has give the Accountable Care Act (ACA) their “seal of approval” in a way. Looks like it's full steam ahead from here. My career has spanned many decades, and I have seen many events come down the road that I feared would change the landscape of medicine in a significant way. In the long run, though, they had far less impact on the way I practiced medicine than I originally envisioned. Early on, there were DRGs, then Medicare reimbursement reductions, risk sharing, capitated contracts, HIPAA, etc. I fear that the ACA will be the game-changer.
I would be the first to defend the art and quality of medical care in the United States, and in the same breath, I fully respect my international colleagues as well. Over the years, I have had the privilege to travel and visit with colleagues in Canada, Italy, Greece, India, and Turkey. The interactions were one of the high points in my career, but I also really appreciate all I have at my disposal in the United States to provide care to my patients.
Let's face it—patients have it really good here whether they are willing to acknowledge it or not. How will that change under the ACA? I do not think we will know for years to come. I do know that in its present form, this will be the thing that transforms medical care going forward in this country. No doubt, all citizens need good and easy access to care that is affordable. Every physician would acknowledge that. That is our hope. The ACA fails to embrace free market solutions, which could help mitigate cost and quite mysteriously, it bypassed tort reform all together. Imagine that!
In closing, I want to tell you a story about an interaction I had with a patient the other day. He was in for a follow-up exam post cataract surgery, and as he was leaving, he commented to me that he was very happy his cataracts had matured and that he had his surgery now. I questioned why, and he told me that many of his friends were so fearful of not being able to receive the necessary surgery they would need under the ACA. As he put to me, “All of my friends are getting their eye and joint surgery done now before they can't.” I felt bad for his friends and their fear of change.
Stephen Pascucci, MD, FACS