As lawmakers approach their summer recess, the national debate on health care reform wages on.  Many view President Obama’s proposed health care plan as one of the most crucial issues of his presidency. Politicians on both sides of the aisle are campaigning furiously to bring Americans to their side.  However, what the plan actually proposes and how it would operate sometimes gets lost in the shuffle.  Several Temple health care professionals recently commented on what they foresee.

The basics

Albert Wertheimer, Ph.D. a professor of pharmacy administration at the School of Pharmacy, explains that the main objective of the health care plan is to make health insurance available for all Americans, including the 47 million who are currently uninsured. 

“Health insurance would be portable, independent of where or if one is employed,” he said, “Pre-existing conditions cannot be a reason to deny coverage or charge enormous premiums.”  He went on to say that a federal government-operated plan would exist alongside current commercial plans, in theory offering more competition.

However, Stephen Permut, M.D., chairperson of family and community medicine at the School of Medicine, warns that while the plan has great intentions, there are real problems as it currently stands. 

“Patients covered by the public plan may not be able to keep their current physicians because of the plan’s low reimbursements,” he said warning that government payments in existing public health care plans such as Medicare have failed to keep up with inflation and caused doctors to drop out of the program.

Reforming practices

President Obama’s health care plan would not only attempt to insure every American, but also change the way medicine is practiced.  One example would be shifting patient records from paper to electronic files to save costs and increase efficiency.  Wertheimer believes this is possible.  “Digitized lab results, cardiograms, and X-rays can be sent as e-mail attachments, negating the practice of duplicating tests at other locations, and therefore saving money” he said.

However, Gerard Criner, M.D., director of the Temple Lung Center, said that the shift to electronic records is not a sure thing and warns that it “will take more than a decade to become the standard of documentation.”

Another practice reform is to depend more on certified nurse practitioners (NPs) to provide primary care, therefore alleviating the burden on physicians.  Frances Ward, chair of nursing in the College of Health Professions and Social Work, sees the benefits of such a change, explaining that “family NPs are trained in lifestyle changes, such as a healthy diet, critical to the shift from our current model which focuses on treating acute illness to a new model focused on health promotion and disease prevention.”  These NPs will specialize in growing medical areas such as geriatric and psychiatric care, she explained.

Quality of care

One of the greatest concerns of doctors regarding the proposed health care plan is the quality of care involved.  Criner says that current HMO’s and the practice of pre-certification, both of which he believes operate similarly to Obama’s plan, “increase the overhead of care but don’t improve care delivery or outcome.”  He thinks the main focus of the plan should instead be funding the medical education of current clinicians, therefore improving health care by eliminating inefficiencies.

Permut echoes these sentiments saying that there is a “concern that the government will establish protocols for care based primarily on cost savings rather than quality care.”  He believes that many Americans could lose the quality care they have now if they shift to the government option.

However, Mary van den Berg-Wolf, MD., deputy director of the Comprehensive HIV Program at the School of Medicine, thinks the system is broken as is. 

“There are great inequalities, where the well-off members of society get care which is largely specialist driven,” she said.  She also stated that there is an overabundance of specialized testing in the medical field, and that “we need more primary care where there is not any financial incentive for the doc to order more tests.”

Although local doctors have yet to come to a consensus on the current health care reform, there is one thing for sure: the health of the country could be said to now rest on lawmakers’ shoulders.

-- Kyle Bagenstose