The Health Care Reform Bill: A Much Needed First Step

At long last Congress and the President took some action to improve the outdated and inefficient health care "non-system" that is exceedingly expensive even though many millions of Americans have no health care coverage.

In 2010, Congress passed and the President signed a health reform bill, officially termed the Affordable Health Care for America Act. Already the Republican-dominated House of Representatives voted to veto the bill, an action not supported by the politically more evenly divided Senate. The Act is far from perfect, and I would like to see a more nonpartisan effort to improve some of the provisions in the huge and somewhat hastily prepared bill.

An obsolete health care system

I agree with Jordan J. Cohen, past president of the American Association of Medical Colleges (AAMC) and now a professor of Medicine and Public health at George Washington University, who wrote "Our health care system is not broken--it’s obsolete." In a recent issue of The Pharos, a quarterly publication of Alpha Omega Alpha Honor Medical Society, Cohen points out that our health care system was designed to deal mainly with acute and often self-limited illnesses. Health care is now burdened not only with rising costs, partly attributed to the increasing number of people with chronic diseases and disability, but also with wide variations in the practice of medicine in different parts of the country and disparities in health care even among those with health care insurance. He calls for much more fundamental changes in the way we deliver and pay for medical care.

Nurse practitioners may be part of the solution

Cohen suggests that the health care bill provides a possible opportunity to carry out a more extensive revamping of medical care in this country. The Act includes demonstration projects to "implement and evaluate innovative approaches to organizing and delivering health care." Certainly there won’t be enough primary care physicians to handle the influx of additional patients newly covered by health insurance. So, one necessary change will be an added use of nurse practitioners and other ancillary personnel to help take care of these patients.

What are the benefits you can expect from this new bill?

Already evident are clear benefits for people with health care insurance. These include:

• Insurers must allow children of policy holders to remain covered by their parent’s  plan through age 26 unless they first obtain a job that provides health care coverage.
• Coverage can’t be denied to children with preexisting conditions.
• By 2014, insurers will either be prohibited or severely restricted from making exclusions for preexisting conditions or some other factors like age, gender, and employment status.
• Caps on annual and lifetime coverage will not be permitted.