MCMS Physician Winter 2017 - 4

mon t m e d s o c .c om

Editor's Comments

Keep the Letters Coming
Didn't see that one coming.
The 2016 election, with its
ups-and-downs, twists-and-turns,
endless ads and witty sound bites,
is now in the rear-view mirror.
By the time this article comes to
press, we would have inaugurated
President Donald J. Trump, and
with him, an era of potentially
significant disruption.
So what does that mean for
American healthcare? There's been
a lot of rhetoric over the past two
years, but what, if anything, will actually change? However one
feels about the Affordable Care Act (or politics in general), one
thing is certain: the ACA is on the chopping block. Campaign
promises aside, where we go from here will affect us all.
Our feature article this issue will be a comprehensive piece
looking at the possible alternatives following ACA repeal.
Tax deductions, health-savings accounts, selling insurance
across state lines-all will be explored. Alongside it will be two
opinion pieces-one for, and one against, keeping President
Obama's healthcare law. It is my intention, and that of the
editorial board, to inspire discussion amongst our members
about this most important topic.
To that end, I am pleased to announce our very first
"Letter to the Editor" column, one which I hope will recur in
each issue. One of our readers provided an opinion on the last
issue's article about physicians and ethics, and we are pleased
to publish his feedback (along with my response). With all the
passion and fury that has surrounded our political discourse, we
mustn't lose sight of the importance of policy. In a campaign
that was characterized by insults and sound bites, something
got lost-solutions for our country.
While I don't want to turn this into a "left vs. right/D
vs. R" debate, I do recognize that strong opinions exist on the
issues which divide us-healthcare included. On a personal
level, I find myself torn: both my father and grandfather
were private-practice physicians, whose fierce independence

was matched only by their dedication to their patients, each
of whom was to them like members of their own family. I
grew up listening to war stories about heart attacks witnessed,
strokes interrupted, and high-speed beelines to the emergency
room at Einstein. As I matured, the lessons I took from this
produced a decidedly conservative bend: the less outside
interference in healthcare, the better. It was a mindset that
stayed with me throughout college, medical school, and the
first part of residency.

When Life Happens, Opinions Change
Then I got sick.
With the diagnosis of resurgent Crohn's, I suddenly went
from physician to patient. By the age of 33, I had major surgery,
and the shock of my seven-day hospital bill-$93,000-was
matched only by the relief I felt in having excellent insurance,
which paid all but $250 (mostly television charges and
professional fees). Suddenly, I was forced to think in insurance
terms-actuarial risk, lifetime limits, and the dreaded phrase,
"pre-existing condition." Sentenced to frequent doctors' visits
and expensive medications for the rest of my life, the question
of "what happens if I someday can't pay" jumped to the
forefront of my mind. Yes, I had good insurance, but it was
employer-based. What if I got too sick to work? Would I lose
my house, my savings? Who would help me, and for how long?
Fortunately, it's a question I haven't yet had to answer, but it's
one I haven't forgotten either.
Then came the ACA.
On paper, it looked both good and bad. Protections for
people like me, incentives for the healthy to purchase insurance,
thereby spreading the cost-and risk-of covering the sick
around. Coverage for preventative services, the elimination
of pre-screening denials in the healthcare market. Of course,
paper and practice are rarely in sync, and the reality turned
out to be quite a bit different. Overnight, co-pays shot up,
themselves soon to be replaced by co-insurance. Flat-fees
became multi-thousand dollar-per-year deductibles, and
government claims touting the record numbers of Americans

MCMS PHYSICIAN 4 WINTER 2017


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Table of Contents for the Digital Edition of MCMS Physician Winter 2017

MCMS Physician Winter 2017 - 1
MCMS Physician Winter 2017 - 2
MCMS Physician Winter 2017 - 3
MCMS Physician Winter 2017 - 4
MCMS Physician Winter 2017 - 5
MCMS Physician Winter 2017 - 6
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