Column by Thomas Duncan
The positive impact of Obamacare cannot be disputed. Millions of Americans are now eligible to enroll in health plans and receive health benefits. The impact is immeasurable.
The utilization of primary and specialty care physicians will undoubtedly initially increase health care spending as a whole. That said, over time the proactive preventative measures employed by newly insured American citizens will greatly reduce our nation’s healthcare expenditures.
Prior to the passage of the Affordable Care Act, our nation’s healthcare system was discriminatory to both lower and middle wage workers. The true cost to live exceeded the threshold for income to qualify for Medicaid; people that had to work lower and middle wage jobs made too much income to qualify; most employers for those jobs could not afford to pay health insurance premiums for them (even if they did cover a substantial portion, many of the employees could not afford the remainder of the premium). Compounding the issue of affordability, was the consistent upward trend of the actual cost of health care delivery that had been driving a consistent upward trend in healthcare insurance premiums.
The Affordable Care Act today is changing the healthcare industry in a positive way. The health insurance industry will now be subject to federal regulations which will assure that everyone is treated fairly and equally. Further, rates will be monitored to make sure that most of the premiums you pay will go towards providing health care and not insurance company profits and administrative expenses, such as multi-million dollar insurance company executive salaries. No longer will health insurance companies be able to charge exorbitant rates, deny or limit coverage, and pick and choose the healthiest while making life difficult for those with debilitating conditions. No longer will health insurance companies be able to charge exorbitant rates, deny or limit coverage, and pick and choose the healthiest while making life difficult for those with debilitating conditions.
There will also be more individualized and personalized health care options for American citizens as health care for all is expected to improve the innovation of physicians, hospitals and insurance companies by encouraging and rewarding better health care outcomes, more home and community based medicine, and less unnecessary hospitalizations and emergency room visits. Our hospitals are responding to the challenges by creating new programs which center on improving access to care for each individual patient. The new health programs are expected to provide more health education and support services to improve every patients’ overall functionality.
For example, Trusted’s Health and Wellness Outreach Center is the first of its kind in the country. It does not treat patients clinically; however it provides key services to help members optimize the use their entitled health care benefits. The services our center provides includes but are not limited to onsite nurse case management, one-on-one diabetes coaching, outreach, yoga classes, cooking demonstrations, as well as adult and child resource libraries. Our center services 500 members per month to assist them in PCP selection, navigating the health care system, prescription management, blood pressure and BMI monitoring, and other highly valuable services.
As the government and its public and private partners focus on execution, small-business owners and eligible Americans should become students of the new laws so they can optimize their utilization. There will be more individualized health care for more folks as health care for all is expected to improve the innovation of physicians, hospitals and insurance companies by encouraging and rewarding better health care outcomes, more home and community based medicine, and less unnecessary hospitalizations and emergency room visits.
Thomas Duncan is CEO of Trusted Health Plan (District of Columbia) Inc.
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