ER-Forum Blog

So what will health care reform mean to Emergency Medicine?

Well it's actually happened.  We now have "healthcare reform". After a seemingly endless and wildly partisan debate, President Obama has signed into law an historic healthcare reform package. But even a week later, as an emergency physician, I'm still not sure what it all means. However, one thing is true for all of us - physicians, nurses, physician assistants, nurse practioners, administrators and patients - there will be change.

For those of you trying to sort out what it all means, I recently came across an article in Healthleadersmedia.com that does a good job of highlighting how the healthcare reform provisions kick in over ten years.  

As we still deal with the seemingly never-ending arguments in this country about the bill, it's interesting to get an outsider's opinion of what our country is about to do with its healthcare system. This article in Germany's Spiegel Online presents the argument that what's good for the US (healthcare reform) may not be positive for the president or for the rest of the world.

So the questions are: what does it mean to Emergency Medicine? How will it affect how I practice my medicine? And what's going to happen with reimbursements?"    

The obvious is there will be more people with medical insurance seeking health care. Emergency physicians know what that means. There will be more people chasing down an already inadequate supply of primary care physicians. So there will be more patients coming to the only other game in town-emergency departments.

With those increased patients will come even more government regulations and expectations of performance. Very likely much of the reimbursement will be tied to performance measures of some kind and there will be increased government scrutiny of billing practices. Expect lots of audits to reduce fraud and abuse.

As there is no money allocated for illegal immigrants, these patients will continue to come to our emergency departments. The worry is there will be a reduction in the money available from cost shifting to pay for those patients. We will see an increase in the use of physician extenders-PAs and NPs. The final question is whether this is the beginning of better days or the beginning of more frustration with government intrusion. Most likely it will be a little of both.

Change is never easy. And something as far-reaching as healthcare reform is the most monumental piece of legislation since the sixties. In the end, I am hopeful that the "good" will far outweigh the "bad".  It's time to move the country forward. We have debated our ethical responsibilities to our fellow citizens long enough.

What are your thoughts and fears on the healthcare reform bill?