The ACA and You

The furor over the Affordable care Act has died down slightly, though I'm still seeing the occasional Facebook post or email with some rumor, or politicization, or misrepresentation. I don't think that's going away, though it will probably stay on simmer until we get closer to the election.

But that small bit of "down time" provides a good opportunity for people to step back and think carefully about what is in the ACA law -- the good and the bad. (And, as most of you know, I think the good parts have to do with things like pre-existing conditions and other matters that pertain to cancer patients.)

In that spirit of finding out as much as we can about the good and the bad, I'm offering a link to an article by the always awesome Betsy de Parry, lymphoma advocate, home builder, TV host, and writer. Her most recent Candid Cancer column is called "Beyond Politics: The Affordable Care Act, Your Doctor and You."

It features an interview with the heads of two hospitals: Dr. Ora Pescovitz, CEO of the University of Michigan Health System, and Rob Casalou, CEO of the St. Joseph Mercy and Livingston Hospitals. Betsy's reasoning for interviewing these two subjects is that they are on the front lines, and as heads of hospitals, they will have a perspective that is broader than any single entity (patient, doctor, or politician). They are less concerned (if at all concerned) with how this will affect the November election, and more concerned with how it will affect patients, doctors, and quality of care.

It's a very interesting interview, and while the two admit that there are some questions that they just cannot answer yet, there are other insights that they offer that they seem pretty sure about. A few excerpts:

• "Dr. Pescovitz: One of the big things that the ACA emphasizes is quality of care — are doctors and their teams doing everything for patients that we know is proven to work and that can keep people healthy? And, it's tying payment to performance on quality measures and patient satisfaction. This is a big change for our industry and, quite frankly, one that is a long time coming."
• "Q. Serious illnesses such as cancer may require periodic, long term or lifelong treatment. Is there anything in the law that will prevent our doctors from treating us at any time in the course of our illnesses?
  Mr. Casalou: I don't see anything in this law that will prevent or withhold appropriate care to patients."
• "Dr. Pescovitz: The ACA is already funding a wide range of research that compares medical treatment options and gives us valuable information on what works and what doesn't."
•  "Q. There is speculation that the ACA is driving doctors who are currently practicing out of medicine and that it will drive the best and the brightest young people to professions other than medicine, which, of course, will mean fewer doctors to treat more people. Are you seeing any evidence of this?
  Dr. Pescovitz: ...I don't think the ACA is driving people away from medicine. It would be premature to draw such a conclusion. Actually, more young people are applying to medical school than ever before — 7,000 more nationwide last year compared with a decade ago!"

Clearly, I have a very particular intetest in the ACA as a cancer patient. I am also someone with a stable job and very good health insurance (for which I am infinitely thankful), which also narrows my perspective. But, as I said a few weeks ago, I'm also someone who has seen several people die because they lost their insurance -- that probably colors my perspective most of all.

So while this one interview won't answer all of the questions that people have about the ACA, I hope it serves as one more piece in peoples' ongoing education. I'll say it again: there's just too much at stake for this law to be repealled outright. Change it, make it better, but don't take away the gift that has been given to cancer patients.

(And I'll say this again, too: thanks for another great article, Betsy.)