Supreme Court upholds healthcare reform law: Dermatologists react to recent ruling

Supreme Court upholds healthcare reform law: Dermatologists react to recent ruling


Washington —  Thursday’s five-to-four vote by the U.S. Supreme Court to uphold the Patient  Protection and Affordable Care Act (ACA) as constitutional will result in  sweeping healthcare system changes for patients and their doctors.

Justices ruled the individual mandate requiring most Americans to obtain health insurance or  pay penalties starting in 2014 is constitutional, as a tax, according to news  reports.

As part of the law, Medicaid will expand to including  millions of low-income Americans. The opinion opens the door for Washington to  offer more funding to states to expand the program, but says the federal  government cannot withhold existing Medicaid funds from states for not  participating.

Susan Weinkle, M.D.

These big-news items appear to be good moves for  dermatologic and other patients, according to American  Society for Dermatologic Surgery President Susan H. Weinkle, M.D. It’s the  unknown nuances of the 2,000-page reform document that remain a concern, she  says.

The good news: Dermatologists will have a greater number of  people having access to lifesaving care during the current skin cancer  epidemic, Dr. Weinkle says.

“However, we … the American Society for Dermatologic   Surgery, are still extremely concerned about some provisions of this healthcare  reform. Specifically, that Medicare’s flawed payment formula, sustainable  growth rate, has not been addressed. The Medicare Independent Payment Advisory  Board will have few physician representatives, and that’s a concern to us.  Also, the issue of liability reform has not at all been addressed.

“So, from the ASDS perspective, see it as a mixed bag for  dermatologic surgery,” Dr. Weinkle says.

Daniel Siegel, M.D.

Daniel M. Siegel, M.D., president of the American Academy of Dermatology Association, agrees:

“Throughout   the health reform debate, the American Academy of Dermatology Association has  supported the principles of quality care, efficiency, and a patient-centered approach  to health care delivery,” Dr. Siegel said in a statement. “While, in many  respects, the health system reform law does not fully align with the AADA’s  health reform principles, there were some positive changes with respect to  insurance reform, the expansion of health care coverage to more Americans, and  strengthening of wellness efforts that were included. Unfortunately, the ACA  missed an opportunity to permanently fix the flawed Medicare physician payment formula or enact meaningful liability reform, and created the Independent  Payment Advisory Board (IPAB), all of which threaten to undermine access to  care and destabilize health care delivery.”

Sandra Read, M.D., a Washington-based dermatologist and  chairwoman of the AAD’s political action committee SkinPAC, says the ruling lays  promising groundwork, but the specialty has work to do to ensure proper  reimbursement from a growing patient base.

“This means that 40 million Americans will get health insurance  and, therefore, access to healthcare. This is good for Americans — it will help  create a healthier population,” Dr. Read says. “Our specialty needs to make  sure that our patients skin health is protected, and that dermatology services  are covered for our newly insured patients.”

Greater accessibility to dermatologic care may also mean  catching skin issues and diseases in earlier stages, Dr. Read says.

Sandra Read, M.D.

“Because more people now have access to dermatology care, we  can hopefully decrease the ravages of skin cancer and skin diseases, which  impact our patients’ lives and their ability to work and live healthy lives. I am hoping that patients will come in earlier to my  dermatology practice when they develop a rash, or notice a changing mole,” she  says.

AMA input

In a statement the day of the ruling, the American Medical  Association lauded the Supreme Court’s decision.

“This  decision protects important improvements, such as ending coverage denials due  to pre-existing conditions and lifetime caps on insurance, and allowing the 2.5  million young adults up to age 26 who gained coverage under the law to stay on  their parents’ health insurance policies. The expanded healthcare coverage  upheld by the Supreme Court will allow patients to see their doctors earlier  rather than waiting for treatment until they are sicker and care is more  expensive,” The AMA wrote. “The decision upholds funding for important research  on the effectiveness of drugs and treatments and protects expanded coverage for  prevention and wellness care, which has already benefited about 54 million  Americans.

“The  health reform law upheld by the Supreme Court simplifies administrative  burdens, including streamlining insurance claims, so physicians and their staff  can spend more time with patients and less time on paperwork,” the AMA  continued. “It protects those in the Medicare ‘donut hole,’ including the 5.1  million Medicare patients who saved significantly on prescription drugs in 2010  and 2011. These important changes have been made while maintaining our American  system with both private and public insurers.”

The ruling is considered a victory for the Obama  Administration, and could provide a boost for President Obama’s re-election  campaign. The controversy surrounding “Obamacare” continues, however. “Today’s  ruling underscores the urgency of repealing this harmful law in its  entirety,” House of Representatives Speaker John Boehner said in a  statement minutes after the ruling.

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