Earlier today, D Healthcare Daily Editor Steve Jacob offered his opinions on the impact of the Supreme Court’s decision to uphold the Affordable Care Act. Steve and assistant editor Jessica Melton have since checked in with healthcare executives and physicians across North Texas to get their reactions. Here’s their report:
Dallas-Fort Worth healthcare providers say the Supreme Court’s ruling offers a clearer path to what the healthcare landscape will be for the rest of the decade.
Doug Hawthorne, president and chief executive officer of Texas Health Resources, said the court’s decision lifts the “cloak of uncertainty. This gives clarity to the issue of insurance coverage. When people are uninsured or underinsured, they often wait too long to access the system. Then it becomes more expensive. The more this encourages people upfront to use the system, the better.”
W. Stephen Love, president and chief executive officer of the Dallas-Fort Worth Hospital Council, pointed out in a statement that more than 4 million Texans lack health insurance.Â “(The law) is very important since Texas has a 27 percent uninsured population which is the highest in the nation. In the Dallas-Fort Worth area, the uninsured percentage is closer to 30 percent. Currently, 1.2 million Texas children have no medical insurance and approximately 40 percent of mothers do not receive appropriate pre-natal care.”
Joel Allison, president and chief executive officer of Baylor Healthcare System, said the ruling “validates the pathways we have put in place. We have been moving toward (the ACA mandates). This reinforces the opportunity to own, joint venture or partner (with others) to provide the full continuum of care, and connect all of that digitally.”
Erin Carlson, health policy professor at the University of North Texas Health Science Center, said she had faith that the Supreme Court would “come up with something no one expected and be fair. This (law) is life-changing for a lot of folks. Millions of people have been making life-altering decisions–having babies, marriage, divorce, holding onto jobs–simply because of health insurance. This (ruling) is huge.”
John McCracken, clinical professor of healthcare management at the University of Texas at Dallas, said he was surprised that the court ruled that states would not be penalized if they opted out of the ACA’s Medicaid expansion. “Nobody thought that the court would invalidate that, but they did. That’s going to have a huge impact on Texas (because of its opposition to the law,” he said.
Robert Earley is president of Fort Worth’s John Peter Smith (JPS), a public hospital that treats a significant number of uninsured patients. He said, “Texas has the highest number of uncompensated-care patients in the nation. Hopefully, state leaders will look at every opportunity to overcome that. And we hope they will focus on putting the patient first. The ruling keeps in place what we knew was out there and emphatically tells us these are the rules of the game. Certainly there is a political element to this. But for us (in healthcare), we see what’s coming and we’ve been planning for it for the past two years.”
Local physicians also believed the ruling provided clarity, but many said the law failed to address several of their concerns.
Rick Snyder, Dallas cardiologist and president of the Dallas County Medical Society, said, “Today’s health care system is riddled with hundreds of regulations imposed by federal health law that do little to improve patient care, but instead divert our time and energy away from our patients. As physicians, we are spending more and more time with paper than with patients.Â We need to find what’s missing, keep what works, and fix what’s broken in the new law.”
Snyder said the law is too focused on protecting hospitals, pharmaceutical companies and medical device makers while neglecting what he predicts will be physician shortage “meltdown” because of insurance-coverage expansion.
Shelton Hopkins, Dallas orthopedic surgeon, said, “It’s a step in the right direction, especially symbolically. It says that we think all Americans deserve coverage, regardless of whether or not they can pay for it. A lot of physicians take care of patients with little or no payment. We will never finish working on our healthcare system. There isn’t a country in the world that is completely happy. There’s always tinkering, and we have some serious tinkering to do. ”
Christopher Crow, a family physician in Plano, said, ” This gives all of us–doctors, employers, patients and all America–some sense of certainty about the law so we can start preparing for its changes in 2014. As a family doctor, there are plenty of provisions that support primary care as the anchor of healthcare reform that I’m pleased will continue. (However), with an existing shortage of physicians in Texas it could delay the ability of patients to get in to see a doctor or worse overrun our emergency rooms with non-emergency problems.”
David Winter, president of HealthTexas Provider Network, which employs more than 500 physicians locally, also mentioned the likely burden of the newly insured on local physicians. “Who’s going to take care of them? Everyone is busy in North Texas. We are struggling to have enough primary-care physicians right now. This doesn’t solve the physician shortage. We are working hard on recruitment, training, and technology to provide more efficient and better distributed care.”
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