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Where Were You When the Health Reform Law Passed?
EDITORIAL J Oral Maxillofac Surg 69:577-578, 2011
Where Were You When the Health Reform Law Passed? “I am tired of hearing it said that democracy doesn’t work. Of course it doesn’t work. We are supposed to work it.” — Alexander Woolcott
sufficient providers from whom to choose. I would like access to the latest technologies, pharmaceuticals, and surgical techniques that have been shown to improve outcomes for diagnoses that I have. I would like to have some reasonable assurance that my ability to get appropriate care in the future will not be dependent upon my age, diagnoses, or past claims history. If I change jobs I would like to be able to keep my chosen healthcare providers or be able to transfer care seamlessly. As a taxpayer, I want a healthcare system that allows for timely cost effective quality care. I want the doctor-patient relationship to be unencumbered. Prevention of disease, evidence based healthcare decisions and a renewed emphasis on the importance of individual responsibility in living a healthy lifestyle should be prominent in all taxpayer supported models. Politicians and policy makers must consider the tough decisions necessary to control cost such as end-of-life care, evidence-based decision making, and alternative reimbursement mechanisms that reward effective care not volume of care. As a small business owner I have other concerns. I want opportunities to provide medical benefits to my employees but not regulations mandating that I do so. The benefits need to be cost effective and deductibility as a business expense is important. I want to be able to offer my employees quality health care and options. I want health care policy that provides some assurance of stability so that I can plan for the future. As you can see from the four perspectives illustrated above, even one person can struggle with identifying the attributes that belong in healthcare policy. What works for me as a healthcare provider may not work for me as a small business owner or a taxpayer. What am I to do? What you shouldn’t do is sit on the sidelines and watch. I would suggest introspection, education and engagement. Consider the issue of health care from some of the perspectives noted and consider others that might be pertinent to you. Educate yourself about the issues and solutions recommended by other stakeholders. Inquire about the positions of your legislators. Engage policy makers and make your opinions known. Do this in your community, state and in Washington, DC. It is important to be involved, be it through OMSPAC, the AAOMS OMS Action Network, your state OMS society, or on your own time. How
Where were you when the health reform law, the Affordable Care Act passed? Perhaps it would be more appropriate to ask where you were while the bill was being developed? Did you make any effort to impart the unique knowledge you possess as an oral and maxillofacial surgeon to those creating this bill? Despite the enormity of health reform and the tangled web that health care policy weaves in our society, most of us limited our participation to watching from the sidelines and “Monday morning quarterbacking.” Why does that occur? Apathy? Laziness? Lack of knowledge about the issues or how to contribute to the process? Distain or distrust of the political process? For those of us content to live with what we are dealt any of those may be sufficient. For those who are not, none are acceptable. Believe it or not we have all been invited to the dance and can choose whether or not to attend. If we do go, we will note that there are many dance partners and interestingly enough we each may occupy many roles in the dance. Allow me to provide some examples. As a health care professional, the rules and regulations imposed by health care policy on the business aspect of our practices should be enough to get our attention and spur comment or action. The “red flag” rules, proposed 1099 requirements for expenditures over $600 and pending electronic health record requirements are but a few examples. Likewise, our primary responsibility, which is patient care, is interfered with on both an overt and more subtle basis. Our abilities to provide patients with timely and appropriate care can become entangled in bureaucratic mazes that end up in denial of care at one extreme or subtly alter the patterns of practice of healthcare providers so that pitfalls can be avoided, potentially to the detriment of patients who do not receive the most appropriate therapies. Mechanisms designed to finance health care clearly affect our ability to develop sustainable business models with well trained staff and current technologies. As a patient and recipient of healthcare, I have different concerns. I want the best care available and at a reasonable cost. I want to have the right to choose with whom I entrust my care and ideally there should be 577
578 else can we expect elected officials to take the positions we want them to take unless we impart our own knowledge and concerns to them. The legislative process has often been described as similar to making sausage. There are a lot of ingredients that are combined to create a whole. Each ingredient lends something to the final product and may alter the flavor. We may not get everything that we want but we should savor everything we get into the mix, provided we take the time to get involved.
EDITORIAL “The most important political office is that of private citizen.” — Louis Brandeis DANIEL J. KLEMMEDSON, DDS, MD IMMEDIATE PAST CHAIR, ORAL AND MAXILLOFACIAL SURGERY POLITICAL ACTION COMMITTEE (OMSPAC)
© 2011 American Association of Oral and Maxillofacial Surgeons doi:10.1016/j.joms.2011.01.020
Where Were You When the Health Reform Law Passed? “I am tired of hearing it said that democracy doesn’t work. Of course it doesn’t work. We are supposed to work it.” — Alexander Woolcott
sufficient providers from whom to choose. I would like access to the latest technologies, pharmaceuticals, and surgical techniques that have been shown to improve outcomes for diagnoses that I have. I would like to have some reasonable assurance that my ability to get appropriate care in the future will not be dependent upon my age, diagnoses, or past claims history. If I change jobs I would like to be able to keep my chosen healthcare providers or be able to transfer care seamlessly. As a taxpayer, I want a healthcare system that allows for timely cost effective quality care. I want the doctor-patient relationship to be unencumbered. Prevention of disease, evidence based healthcare decisions and a renewed emphasis on the importance of individual responsibility in living a healthy lifestyle should be prominent in all taxpayer supported models. Politicians and policy makers must consider the tough decisions necessary to control cost such as end-of-life care, evidence-based decision making, and alternative reimbursement mechanisms that reward effective care not volume of care. As a small business owner I have other concerns. I want opportunities to provide medical benefits to my employees but not regulations mandating that I do so. The benefits need to be cost effective and deductibility as a business expense is important. I want to be able to offer my employees quality health care and options. I want health care policy that provides some assurance of stability so that I can plan for the future. As you can see from the four perspectives illustrated above, even one person can struggle with identifying the attributes that belong in healthcare policy. What works for me as a healthcare provider may not work for me as a small business owner or a taxpayer. What am I to do? What you shouldn’t do is sit on the sidelines and watch. I would suggest introspection, education and engagement. Consider the issue of health care from some of the perspectives noted and consider others that might be pertinent to you. Educate yourself about the issues and solutions recommended by other stakeholders. Inquire about the positions of your legislators. Engage policy makers and make your opinions known. Do this in your community, state and in Washington, DC. It is important to be involved, be it through OMSPAC, the AAOMS OMS Action Network, your state OMS society, or on your own time. How
Where were you when the health reform law, the Affordable Care Act passed? Perhaps it would be more appropriate to ask where you were while the bill was being developed? Did you make any effort to impart the unique knowledge you possess as an oral and maxillofacial surgeon to those creating this bill? Despite the enormity of health reform and the tangled web that health care policy weaves in our society, most of us limited our participation to watching from the sidelines and “Monday morning quarterbacking.” Why does that occur? Apathy? Laziness? Lack of knowledge about the issues or how to contribute to the process? Distain or distrust of the political process? For those of us content to live with what we are dealt any of those may be sufficient. For those who are not, none are acceptable. Believe it or not we have all been invited to the dance and can choose whether or not to attend. If we do go, we will note that there are many dance partners and interestingly enough we each may occupy many roles in the dance. Allow me to provide some examples. As a health care professional, the rules and regulations imposed by health care policy on the business aspect of our practices should be enough to get our attention and spur comment or action. The “red flag” rules, proposed 1099 requirements for expenditures over $600 and pending electronic health record requirements are but a few examples. Likewise, our primary responsibility, which is patient care, is interfered with on both an overt and more subtle basis. Our abilities to provide patients with timely and appropriate care can become entangled in bureaucratic mazes that end up in denial of care at one extreme or subtly alter the patterns of practice of healthcare providers so that pitfalls can be avoided, potentially to the detriment of patients who do not receive the most appropriate therapies. Mechanisms designed to finance health care clearly affect our ability to develop sustainable business models with well trained staff and current technologies. As a patient and recipient of healthcare, I have different concerns. I want the best care available and at a reasonable cost. I want to have the right to choose with whom I entrust my care and ideally there should be 577
578 else can we expect elected officials to take the positions we want them to take unless we impart our own knowledge and concerns to them. The legislative process has often been described as similar to making sausage. There are a lot of ingredients that are combined to create a whole. Each ingredient lends something to the final product and may alter the flavor. We may not get everything that we want but we should savor everything we get into the mix, provided we take the time to get involved.
EDITORIAL “The most important political office is that of private citizen.” — Louis Brandeis DANIEL J. KLEMMEDSON, DDS, MD IMMEDIATE PAST CHAIR, ORAL AND MAXILLOFACIAL SURGERY POLITICAL ACTION COMMITTEE (OMSPAC)
© 2011 American Association of Oral and Maxillofacial Surgeons doi:10.1016/j.joms.2011.01.020