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Debate: Should the ACA be Repealed or Restructured?

Debate: Should the ACA be Repealed or Restructured?

Welcome to the latest edition of the Physicians Practice Pearls Podcast. In this podcast, we'll aim to bring you some of the most interesting, influential guests in the healthcare industry. If you have any ideas for podcast guests or topics, shoot us an email at editor@physicianspractice.com.


This week we present a supersized version of the podcast. We were inspired by last night's showdown between presidential candidates, Hillary Clinton and Donald Trump and decided to offer our own debate.

This year's Great American Physician Survey exemplified the split that divides doctors on the Affordable Care Act (ACA). Forty-seven percent of respondents say the ACA has done a great disservice to Americans; 45.5 percent said it has been mostly good, but not all good; and the remaining group say it's been great for all Americans.

Many physicians are indeed, frustrated with the health law, but have different views on what should be done with it. Some, like Paul Norwood, an endocrinologist out of Fresno, Calif., are of the belief that it's beyond repair. He says it should be repealed and replaced. Others, like Arvin Nanda, a family medicine physician at a three-doc practice in Dayton, Ohio, don't believe that would be an effective strategy to improve healthcare. Nanda is in favor of restructuring the ACA.

Norwood and Nanda joined us to debate the efficacy of the ACA and whether or not it can be salvaged. The two doctors both got a chance to give two-minute answers to four questions and then a one minute response to the other's initial answer. Below are a few highlights from the debate, which can be listened in its entirety above.

Question 1: Make your case, should the ACA  be repealed and replaced or should it just be restructured?

Dr. Nanda: "The ACA should be restructured. Repealing the ACA would cost taxpayers millions of dollars, insurers tons of money, and lots of practices lots of money. We've had 11 to 20 million people get insurance through the ACA, all of a sudden a repeal would leave those people without insurance whatsoever and create quite a quandary for them."

Dr. Norwood: "The ACA should be repealed and replaced. Presently, this country is in dire straits with a $19 trillion debt…the entire medical system, I'd say, has to be replaced. The ACA is an extension of our medical system. The medical system is highly regulated and this is another regulation that is unaffordable…the entire economy can't afford the expense of the ACA and the entire medical system."

Dr. Nanda: "I don't think the regulation is the issue. I think we agree on the competition, there needs to be more competition to lower costs."

Question 2: There have been benefits to the ACA — true or false. Explain your answer.

Dr. Norwood: "There have been benefits to the ACA....50 percent of the people are coming to my office from the ACA that have significant problems with mental illness that have not been previously treated."

Dr. Nanda: "That's a definite true…11 to 20 million more Americans have health insurance because of it, free contraception for employees in certain health plans, Medicaid eligibility has expanded in 26 states...another benefit is there are no annual or lifetime limits on healthcare. There are reasons for regulations at times, health insurance is only concerned with profit, not the care of the patient."


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