MDNews - Central New York

PHYSICIANS, OTHER HE ALTHCARE PROFESSIONALS, HE ALTH INSURERS, PATIENTS AND TA XPAYERS ARE FOLLOWING THIS ISSUE AT THE FEDER AL LE VEL A S IS NANCY NIELSEN, MD, PHD, OF BUFFALO. D R . N I E L S E N WA S president of the American Medica l Association when f o r m e r P r e s i d e n t B a r a c k O b a m a addressed the meeting of the AMA House of Delegates in June 2009. During Obama's speech, he outlined plans for what is now known as the Affordable Care Act (ACA) or Obamacare. Dr. Nielsen recalled in an interview earlier this year that Obama received some boos when he admitted to AMA delegates that he did not favor medica l liability reform, a top objective for physicians and physicians organizations. Dr. Nielsen became the AMA's lead spokesperson on the ACA and subsequently spent two years as an appointee to the newly created Council of Innovative Care. When the AMA made the decision to support passage of the ACA, that deci- sion created controversy among AMA members, many of whom dropped their membership. The AMA, however, was not the on ly physicia n orga nization who publicly supported this legislation approved by the Senate and the House of Representatives and signed into law on March 23, 2010. The ACA did achieve its major objective to significantly decrease the number of Americans who were unin- sured. This year, that total is estimated to be 23 million persons. Replacing the ACA was one of the cam- paign promises of candidate Donald J. Trump. This year on May 4, the House of Representatives passed a bill to repeal and replace Obamacare. The Senate now has this bill and subject under consideration. Small businesses claim that the cost of healthcare insurance for employees has become an unsustainable expense. Health insurers are uneasy about the future of the health insurance market. Many insurers have stopped writing coverage in several states and do not take part in many health insurance exchanges. Before a nd a f ter the House bill wa s approved, ma ny hea lthca re orga niza- tions wa rned about possible negative c on sequenc e s i f t h i s mea s u re u lt i- mately beca me law. A M A President A ndrew W. Gurma n, MD, says that the bill will result in millions of Americans losi n g a c c e s s t o qu a l it y a f ford a ble hea lth insura nce. Those with pre-existing conditions "would face the possibility of going back to the time when insurers would charge them premiums that made access to coverage out of the question," Dr. Gurman continues. The AMA urged that action is needed to improve the current healthcare insurance system. Dr. Gurman calls upon the Senate and the administration to work with physicians, hospitals and provider groups to craft bipartisan solutions so all American families can access reasonable coverage while preserving the safety net for the vulnerable population. Charles Rothberg, MD, President of the Medical Society of the State of New York (MSSNY) states that "it is unfortunate that the health bill would have the effect of watering down our existing protections for pre-existing conditions as a need to reduce premiums." MSSNY estimated that 850,000 New Yorkers would lose cov- erage under the House bill and New York State government would lose a substantial mount of federal funding for health care. Many patient and health provider associa- tions in the state have announced their opposition to the legislation passed in the House. The Congressional Budget Office esti- mates that the House bill would increase the number of Americans without health i nsu ra nce by more t ha n 14 m i l l ion in 2018 with that number rising to 20 mil- lion by 2020 and 24 million by 2026. Rather than replace or repeal the ACA, Dr. Nielsen firmly believes that the ACA should be improved. Recent national polls strongly indicate that the public agrees with her and now support retention of Obamacare. Dr. Nielsen, who is Senior Associate Dean for Health Policy at the University of Buffalo Jacobs School of Medicine a nd Biomedica l Sciences, strongly believes that drug prices must be controlled. Dr. Nielsen admits this may be tough to accomplish because of the great influence of the pharmaceutical industr y in Washing ton, D.C. backed up by large contributions to congres- sional candidates Whether the Senate can be successful in passing a healthcare bill which would be acceptable to the House and the current administration is far from certain. Gerald N. (Jerry) Hoffman was chief executive officer of the Onondaga County Medical Society from 1981 until his retire- ment on Jan. 31, 2014 and is co-author of two books, Medical Malpractice Insurance: A Legislator's View and The History of Local Medical Care, 1806–2006. n BY JERRY HOFFMAN Repeal, Replace or Change ACA? M D N E W S . C O M /// M D N E W S C E N T R A L N E W Y O R K ■ 2 017 H E A LT H C A R E P E R S P E C T I V E ❰❰❰❰❰ 0 5

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