How will the current makeup of Congress affect health care?

Dr. Badlani“I think the negative impact will come from the uncertainty. The implementation of health care reform (ie, the ACA), unfortunately, has not happened smoothly. And every court case and/or every other objection leads to a further delay of full implementation. My personal belief is that everyone in this land should be covered, but that doesn’t seem to happen. The intent was to cover everyone, but that hasn’t happened.

If you happen to live in a state where the expansion of Medicaid is denied, then there is a larger population of patients who are being affected because they don’t have care. 

Our state is considering accepting the expanded Medicaid. The health care secretary I’ve dealt with here feels that they should expand Medicaid, but both state houses are Republican and they won’t pass it.

The uncertainty leads to any health care institution not putting out new initiatives, etc., because they are uncertain about what is going to happen. Everything gets put on hold, and people wait to see what’s going to happen before they start something new.

We clearly need to be changing with the times, and being on hold is actually falling behind.”

Gopal Badlani, MD

Winston-Salem, NC

Dr. Knapp“I don’t think the change in the makeup of Congress from this last election will have any measurable impact on health care this year. The White House will still be able to exert its influence over regulatory agencies and block any action coming out of the bicameral houses unless they have enough votes to override a veto.

I don’t expect that to happen, except perhaps on some minor issues. They may be able to whittle away at some provisions of the ACA, such as the medical device excise tax, but otherwise I think we’re stuck with the health care law for at least the next 2 years.

The overall effect of that will be continued deterioration in access to care and an increase in cost. And it’s not just the ACA. This goes back to the stimulus package passed in early 2009, which required practices to go to electronic medical records. That has also had a negative impact on health care and the relationship between physicians and patients while increasing costs. That should also be repealed, but it won’t happen in the next year or two.”

Peter M. Knapp, Jr., MD

Indianapolis

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“I doubt Obamacare will be repealed. That’s something we’re going to end up having to live with, but I do think we will see the further development of independent physicians being driven toward one hospital system or another. We have two hospital systems in our area. We’re still an independent urology group of about 11 doctors, and we have been able to provide services well to both of these systems. However, there are other doctors in the area who have had to either pick and choose or worry they’re going to be left out in the cold if they don’t pick one system.

What I see happening is that doctors are going to be looking for an alternative so they can maintain their autonomy and security, so I think it’s a good idea for independent physicians to band together. I think insurance companies will also see that as an attractive alternative to the hospital systems, which would clearly be more costly than getting care through an independent group of physicians that are not hospital based.

I think the new makeup of Congress would embrace that type of system because it’s going to be a less costly alternative. An independent group providing that type of care will be less costly, not to mention it will also increase competition.

I would think the Republican Congress would embrace that more from a business and financial standpoint.”

George Boline, Jr., MD

Harrisburg, PA

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