By Larry Fox
Given several months to study the nation’s new landmark health insurance reform bill, members of the Advisory Board of To Your Good Health, A Health Care Newsletter, produced a movie title summary at their most recent meeting at Cape Cod Community College:
“The Good, the Bad And The Ugly.”
Yet, asked for an overall review of this historic legislation, the consensus was unanimous:
A must see…but just wait till the sequel!
First, the good.
In the words of David Rehm, president/CEO of Hospice & Palliative Care of Cape Cod, “I feel quite in the middle about many aspects, but the important thing is that SOMETHING happened. My greatest fear is that nothing would be done.”
And as Dr. Herbert Mathewson, medical director of the VNA of Cape Cod, said, looking forward, “The best thing in it is the spirit of innovation it contains. There are over 250 demonstration and pilot projects in there that are aimed at testing various organizational changes that are designed to reduce costs and improve quality. By including all of these, the legislature admits they don’t have all the answers…but they are willing to try!”
“We’ll have the opportunity to try some of the things we’ve been talking about for years,” Mr. Rehm agreed.
Dr. Arthur Bickford, medical director of Hospice & Palliative Care of Cape Cod, for several years worked in England and gives their national healthcare system high grades. “I’m glad we got something started,” he said, “We have to come up with new ways of delivering healthcare so all the people can benefit.”
Todd Herrmann, vice president of Planning and Development at the Rehabilitation Hospital of the Cape & Islands, called the bill “historic.”
Okay, how about the bad?
Questions centered on two areas: the absence of any type of tort reform, since fear of lawsuits continues to force providers to practice highly expensive defensive medicine. And failure to address the growing shortage of primary care physicians.
Carol Vigliano, clinical liaison for Bayada Nurses, and Rosemary Dillon, Dean of Health Sciences, Social Sciences, and Human Services at Cape Cod Community College, both cited this absence as a major flaw. And Sue Rohrbach, Cape Cod representative for
Senator Rob O’Leary, said that her “disappointed” boss continued to be “actively seeking to address the issue of malpractice costs on the state level.”
Dr. Bickford put the physician shortage personally. “There’s just not enough of me,” he lamented.
One answer, according to Dr. Mathewson, would be a “flurry of programs” to produce more so-called “physician-extenders,” such as Nurse Practitioners and Physician Assistants, to take on some of the tasks in a medical practice.
“From what I hear, we’ll be having a much harder time finding a primary care physician and there may be people who can’t get care in an emergency,” noted Andrew Young, a former trustee of Cape Cod Hospital.”
And the ugly?
This could be the fact that many elements of the bill won’t be implemented for years to come.
“There’s been a lot of cooked spaghetti being thrown at the wall and some of it’s going to stick, and a lot of it’s not. And the way it’s being talked about now is not the way it’s going to be implemented three, four, five years down the road, that’s pretty certain,” warned Van Northcross, regional marketing director for Cape Cod Healthcare.
“We are making more progress than what people think. but we’ll still have to wait till 2014 to see,” predicted Jim Lyons, retired former President/CEO of Cape Cod Healthcare, adding with a grin, “But one thing is for certain, it ain’t gonna be what it was.”