Physicians Practice - July/August 2008 - (Page 34)

HEALTHCARE REFORM Whether or not the Massachusetts model can be applied to the nation as a whole is up for debate. There were a number of factors that made it easier for Massachusetts to implement state-mandated health insurance coverage, including an already low uninsured rate of just 10 percent, compared to the 15 percent national average, a large and thriving healthcare industry, and a $1.5 billion, I can assure you that everyone will have coverage. The way we do it is crazy and expensive. What we do is keep people out of the hospital until they’re deathly ill. So when they come to the hospital, they have to be admitted.” VanderArk’s dream for American healthcare, like most people’s, is a system that covers everyone affordably. He recoils at notions of a govessentially shames his peers into doing it. If they choose not to, they are literally blacklisted. “Every year the medical society posts a directory,” he says, “and if you’re a participant in Doctors Care, your name is in red, and if you’re not, your name is in black. … It’s peer pressure. If your colleagues do it, you better darn well do it too. … This is expected of you if you are a part of our community.” COMPETING PRIORITIES “The solution is to return to a free enterprise system.” CAPITALISM RULES Steven F. Hotze, MD higher mean income than many states. But Americans are watching the Massachusetts experiment closely: If it succeeds, you can bet that reformers elsewhere will point to it as the prototype for a national healthcare restructuring. “We need to think of the provision of good healthcare as crucial to the health of the nation,” says Dimitri. “We need to consider it a national asset that we all beneﬁt from.” MILE HIGH MODEL That’s certainly how Gary VanderArk, a retired neurosurgeon in Denver who today runs Doctors Care, a large clinic for the un- and underinsured, sees it. The self-described conservative Christian says universal healthcare is both a moral and economic imperative, and he blames his own Republican party for America’s failure to attain it. “Healthcare economics is very complicated, and [Republicans] just don’t get it,” VanderArk argues. “And the major thing that they don’t get is that if you take care of everybody, you save money. For example, in Colorado last year, we spent $1.5 billion on taking care of people without insurance. If you give me 34 | PHYSICIANS PRACTICE | JULY/AUGUST 2008 ernment-run system but says other countries have developed schemes that allow the private market to function under federal regulations that mandate coverage and basic beneﬁts, and prohibit insurers from dropping people for getting sick. “What we need to be learning from other countries in the world that have universal healthcare is that you can have private insurance, but you’ve got to have rules for those companies,” he says. “All the government has to do is say, ‘OK, everybody, we’re not going to change anything, but these are the … rules as far as healthcare is concerned.’ That would solve it.” VanderArk, though, isn’t waiting idle. His clinic serves Denver’s growing uninsured population by providing free or reduced-price medical care on a sliding scale, using donated supplies and volunteer physicians and other providers. In 2007, Doctors Care provided $3.5 million in care, all donated by local physicians, labs, hospitals, radiologists, and pharmacies. Most of Denver’s physicians volunteer at least some of their time at Doctors Care. Participation is high at least partly because VanderArk Ferguson, of George Washington University, doesn’t think that attaining universal coverage would be quite as easy as VanderArk suggests. “Is it pie in the sky?” she asks. “It is certainly a reach to say that we can do universal coverage in the current system without a significant change in the finance and delivery aspects of it.” Ferguson’s best-case scenario? “If the person who is elected president this year decides that this is their No. 1 issue, and if they spend all of their political capital and energy in the ﬁrst year of their term to accomplish a health reform package that includes universal coverage, restructuring our ﬁnancing system, and restructuring aspects of our delivery system, I think there’s a good possibility it could happen.” There is no shortage of reform proposals among the presidential candidates. But our collapsing economy, the ongoing war in Iraq, and the housing crisis are surpassing healthcare as voters’ top concerns, says Ferguson. “People are much more aware of those things than they are of the fact that they are teetering on the abyss when it comes to healthcare — that if they lose their job, they’re shot. But most people are not in that situation at the same time … and so you don’t have that same impetus or fear about healthcare as you do about these other things. That’s what makes the debate so difﬁcult.” FACING REALITY Linda Blumberg, a principal research associate at the Urban Institute, a liberal-leaning think tank in WWW.PHYSICIANSPRACTICE.COM http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - July/August 2008

Physicians Practice - July/August 2008 Contents The Bigger Picture: Battle Royale in the EMR Market Letters Physicians Practice Pearls: Hire Right Noteworthy Cover Story: Healthcare Reform: Voting for Change Patient Relations: Dealing with Problem Patients The tech Doctor: Is Self-Service Medicine Inevitable? Technology: Do EMRs Make You a Better Doctor? The Guide Idealab: Cash-Only Care Still Works The Administrators Desk: Who’s in Charge? Ask The Experts What Went Wrong: ‘Why Our Great Idea Didn’t Work’ Coding Start It Up: How to Launch a Practice: Operations Partnership: Don't Let Partner Conflict Destroy Your Practice Appraisals: What’s Your Practice Worth? Getting Advice: How to Hire a Consultant Classifieds Advertiser Index

Physicians Practice - July/August 2008

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