Now that the US Supreme Court has upheld the constitutionality of the Patient Protection and Affordable Care Act, the health care industry will undergo a few changes. We’ve heard what politicians have to say about where Obamacare will take the nation, but WhichWayNC wanted to talk to the doctors who will be treating the new influx of patients. What are their opinions on Obamacare? What are the pros and cons? And what do they foresee changing?
Read on for interviews with two North Carolina doctors.
WhichWayNC: Do you believe that universal health care is needed in America? Why or why not?
Dr. Ladson Gaddy-Dubac: I think everyone needs to have access to primary and preventative health care. With that said, I do not believe the federal government should be in charge of anything, and definitely not health care. We can definitely see how poorly both Medicaid and Medicare are run. The current system is rattled with fraud, waste and expense. The government doesn’t do a good job of managing those programs, so it doesn’t make sense to me why they think they can manage a larger program.
Dr. Stephen Hux: I think you have to be a little bit selective about what things you want to force on people. It’s hard for the government to be in control of people’s personal habits. I think that’s what a lot of the health issues we are dealing with are and no amount of preventative care is going to fix that.
WWNC: What are some problems you see with Obamacare?
Dr. GD: My main problem with it is that it is expanding care without cutting expenses. When (Obamacare) starts, we will have a drastic shortage because we are adding a huge number of patients, and there aren’t enough physicians. And now the government, with programs like Medicare and Medicaid, are slashing doctor reimbursements as a way of cutting costs. This will make it a struggle to keep physicians.
Dr. H: I think Obamacare is primarily focused on money and how we can provide what certain people consider adequate health care within the budget we’ve been given. A lot of different specialty groups have their own opinions on how health care should be run. For instance, we spend a lot of money on mammograms, we spend a lot of money on unnecessary biopsies, but we also pick up some cancer early and save some lives. If you look at it from a statistical point of view, we probably do spend a lot of money for each cancer that we find, but for the person that we save, that’s pretty valuable to them. And so, it comes down to how much are we willing to spend to pick up that cancer and cure them when we know we’re having to do 5,000 mammograms to find that person. The insurance companies will now debate that question, not the physicians.
WWNC: What are some advantages you see with Obamacare?
Dr. GD: I agree with the theory behind Obamacare. If we are able to prevent disease and prevent emergency room visits by having people go to their checkups every year, then we save money. I do agree that we need to make health care more affordable, so people can get cancer screenings and checkups, which helps us take care of people before they get really sick. However, I think many people have that opportunity now and don’t do it. If you don’t have insurance, it can be really expensive to go see a doctor. For basic insurance for my family of three, it is over $400 per month.
Dr. H: There are a lot of uninsured people that get sick and can’t pay their rent, or get fired from work because of too many days absent. Having patients that are insured and can afford their medicine is a good goal, but how are you going to manage that? In the past, insurance companies have only been responsible to share holders. Their goal is to spend the least money possible and still get the highest premiums they can. So if it becomes a matter of how do we make the insurance companies make more money, then that won’t help anybody.
WWNC: How to you think Obamacare will impact patients?
Dr. GD: My greatest worry is that the care will be worse for folks with insurance now. I think a lot of employers aren’t going to provide their employees with insurance because it’s cheaper to take the government penalty than provide it for workers. It’s a hard question to answer: How do we make health care both high quality and affordable for folks?
DR. H: We’ve already had to hire additional nurses just to handle prior approvals. We give them an order and they have to go through and jump hoops to figure out how to get this approved so we can treat our patient. It’s making us take longer steps to get a patient taken care of. We have to delay treatment for a few days and hire more manpower to get the work done.
WWNC: Do you think Obamacare will change the health industry for better or for worse?
Dr. GD: America currently has the most innovative health care system in the world and I think, with this, we’re at risk of losing that. It’s because there are over 20 new taxes that the government will put on the health care. Innovation raises the standard of health care. Essentially, I think that universal health care may mean the standard of health care is lower. Cost-wise, you can’t provide the same level of care while cutting costs and stretching doctors too thin.
DR. H: The government finds one little niche to focus on and say that they’re going to save money by eliminating this, and they put all these big networks in place to enforce it. People who are not medically trained are making the decisions on which of (doctor’s) orders are legitimate and which are not. We’re seeing that we’re getting less and less control over how we can take care of our patients. We’ve been trained with multiple years of schooling and experience to make those decisions, but now we’re not being allowed to make those decisions.
About the doctors
Dr. Ladson Gaddy-Dubac attended medical school at the University of North Carolina at Chapel Hill and finished her residency at Mission Hospital in Asheville in June 2012. She will begin her OB-gyn career at Angel Ob-gyn in Franklin in September.
Dr. Stephen Hux has been a family practice physician for the last 27 years, working at Arcadia Family Practice in Winston-Salem.