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Re: Liking Health Reform but Turned Off by Toxic Politics
LAPAROSCOPY/NEW TECHNOLOGY
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Medicare data set only 10% were participating in an ACO. This rate varied by geographic region and provider gender. Clearly if ACOs are going to achieve their stated goals, specialists have to be motivated to participate in the program. These data indicate that they currently are not. Going forward this situation may change as the new MACRA (Medicare Access and CHIP Reauthorization Act of 2015) regulations take effect and traditional fee-for-service reimbursement becomes more onerous and less lucrative. In the meantime urology as a specialty needs to explore how best to interact with ACOs and identify models that work for the ACO, the urologist and the patient. David F. Penson, MD, MPH
Re: Liking Health Reform but Turned Off by Toxic Politics L. R. Jacobs and S. Mettler Department of Political Studies, Humphrey School of Public Affairs and Department of Political Science, University of Minnesota, Minneapolis, Minnesota, and Department of Government, Cornell University, Ithaca, New York Health Aff (Millwood) 2016; 35: 915e922. doi: 10.1377/hlthaff.2015.1313
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/27076227 Editorial Comment: The Affordable Care Act (ACA), also known as Obamacare, celebrated its sixth birthday this year, and opinion regarding this piece of legislation is as divided as ever. The authors conducted an annual telephone opinion poll of 1,200 adults in 2010, 2012 and 2014 to assess their perception of the ACA. Not at all surprisingly, positive or negative view of the ACA was closely associated with political party affiliation, which is really the underlying problem here. The polarized atmosphere in Washington prevents an intelligent and balanced discussion regarding how best to tackle our national problems around health care. That said, the study seems to indicate that the public perception of the law is changing. For example the proportion of respondents who stated that the law had some or a great impact on increased access to health insurance or medical care increased from roughly 25% in 2010 to 45% in 2014. In fact, among individuals who had an unfavorable view of the law the proportion stating that we should give the law more time to see if it works increased from roughly 18% to 26%. Obamacare is certainly the most polarizing piece of legislation I have seen in my lifetime. It continues to generate intense debate and strongly held opinions regarding its success or failure. As health care providers whose livelihoods are directly affected by the legislation, it certainly hits close to home. That said, we also have a duty to be responsible stewards of the limited health care resources in our nation. It is time for us to abandon our preconceived notions about this law and reexamine its successes and failures to date. There is certainly opportunity to modify the law going forward but we can only participate in the discussion if we are level headed and objective about it. David F. Penson, MD, MPH
Laparoscopy/New Technology Re: Public Perceptions on Robotic Surgery, Hospitals with Robots, and Surgeons That Use Them J. A. Boys, E. T. Alicuben, M. J. DeMeester, S. G. Worrell, D. S. Oh, J. A. Hagen and S. R. DeMeester Keck School of Medicine, University of Southern California, Los Angeles, California Surg Endosc 2016; 30: 1310e1316. doi: 10.1007/s00464-015-4368-6
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26173543
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Medicare data set only 10% were participating in an ACO. This rate varied by geographic region and provider gender. Clearly if ACOs are going to achieve their stated goals, specialists have to be motivated to participate in the program. These data indicate that they currently are not. Going forward this situation may change as the new MACRA (Medicare Access and CHIP Reauthorization Act of 2015) regulations take effect and traditional fee-for-service reimbursement becomes more onerous and less lucrative. In the meantime urology as a specialty needs to explore how best to interact with ACOs and identify models that work for the ACO, the urologist and the patient. David F. Penson, MD, MPH
Re: Liking Health Reform but Turned Off by Toxic Politics L. R. Jacobs and S. Mettler Department of Political Studies, Humphrey School of Public Affairs and Department of Political Science, University of Minnesota, Minneapolis, Minnesota, and Department of Government, Cornell University, Ithaca, New York Health Aff (Millwood) 2016; 35: 915e922. doi: 10.1377/hlthaff.2015.1313
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/27076227 Editorial Comment: The Affordable Care Act (ACA), also known as Obamacare, celebrated its sixth birthday this year, and opinion regarding this piece of legislation is as divided as ever. The authors conducted an annual telephone opinion poll of 1,200 adults in 2010, 2012 and 2014 to assess their perception of the ACA. Not at all surprisingly, positive or negative view of the ACA was closely associated with political party affiliation, which is really the underlying problem here. The polarized atmosphere in Washington prevents an intelligent and balanced discussion regarding how best to tackle our national problems around health care. That said, the study seems to indicate that the public perception of the law is changing. For example the proportion of respondents who stated that the law had some or a great impact on increased access to health insurance or medical care increased from roughly 25% in 2010 to 45% in 2014. In fact, among individuals who had an unfavorable view of the law the proportion stating that we should give the law more time to see if it works increased from roughly 18% to 26%. Obamacare is certainly the most polarizing piece of legislation I have seen in my lifetime. It continues to generate intense debate and strongly held opinions regarding its success or failure. As health care providers whose livelihoods are directly affected by the legislation, it certainly hits close to home. That said, we also have a duty to be responsible stewards of the limited health care resources in our nation. It is time for us to abandon our preconceived notions about this law and reexamine its successes and failures to date. There is certainly opportunity to modify the law going forward but we can only participate in the discussion if we are level headed and objective about it. David F. Penson, MD, MPH
Laparoscopy/New Technology Re: Public Perceptions on Robotic Surgery, Hospitals with Robots, and Surgeons That Use Them J. A. Boys, E. T. Alicuben, M. J. DeMeester, S. G. Worrell, D. S. Oh, J. A. Hagen and S. R. DeMeester Keck School of Medicine, University of Southern California, Los Angeles, California Surg Endosc 2016; 30: 1310e1316. doi: 10.1007/s00464-015-4368-6
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26173543