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Healthcare Will Continue to Evolve No Matter Presidential Election


The election is less than two weeks away, and no matter if the Affordable Care Act is preserved or repealed, healthcare continues to evolve.

I can’t help but be caught up in the election debates the past few weeks and months.

It is a hot topic among the medical staff lounge at our hospital, with a surprisingly equal division of Democrats and Republicans, with a smattering of Libertarians. Healthcare reform has been a hot topic in America for as long as I have been a physician assistant. I find it interesting to note that depending on where you stand, “Obamacare” is either viewed as a pejorative statement or a proud label.

From what I can see from my peers and patients, the collective conventional wisdom on the entire Affordable Care Act (ACA) has a negative connection, but when you tease out the components of the law, they are individually viewed in a very positive light.

Nearly everyone supports inclusion of pre-existing conditions, coverage of children, preventative healthcare, reproductive healthcare, etc. Should Gov. Mitt Romney gain the White House in two short weeks, it is my prediction that he will find it exceedingly difficult to wipe Obamacare off the books and start from scratch. I doubt the American public would stand for it, and the sheer enormity of the controversy and legal actions required to make a sweeping repeal will derail the rest of the administration’s agenda.

No legislation or legislative process is ever perfect, but in my opinion, the ACA was a step in the right direction, with room for improvement. There is no reason to repeal and start over, as the problems that have driven the call for meaningful reform have only gotten worse over the years, and will continue to get worse without reform.

Prior to the Supreme Court decision to uphold the ACA, I was at the American Academy of Physician Assistants annual conference and heard some remarkable information from Michael Lovdahl, a consultant in the healthcare industry.

He opined that it didn’t matter what the Supreme Court decided; the health insurance and healthcare industry is already implementing reforms such as accountable care, etc., driven by the monumental economics of the healthcare system. The Court’s decision bolsters a number of ongoing market trends that are likely to continue regardless of future intervention by federal and state lawmakers. These include a shift to payment for value and outcomes and away from fee-for-service, additional focus on prevention and coordination of care, and the increased use of information technology.

Doing nothing, or reversing course, is never an option when faced with evolving challenges. We all need to be flexible, reasonable and realize that “the way in which we have always done it” can’t be continued.

New models of care are being designed to better coordinate care through team-based practice and to promote value to the healthcare delivery system. Because PAs are built for team-based practice, we are ideal healthcare professionals for patient-centered, primary-care medical homes, Independence at Home models of care, chronic care management, and others.

The practice of medicine has never been more complex than it is right now. We have internal, professional demands on us that, at times, can be overwhelming, and stress also comes from external sources when the “world” in which we live seems to change or be unstable.

Yet it is important to keep in mind that a lot of stress comes almost exclusively from things that I have little or no control over.

That is why we all need to separate ourselves, from time-to-time, from that what we can’t control, and engage what we can control. Our hobbies, sports, and joys outside of the professional realm are an important part of our global health, and provide us with a better perspective on our world, and prepare us to perform professionally at the highest levels.

This blog was provided in partnership with the American Academy of Physician Assistants.

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