Running Head: Aordable Care Act 1
Affordable Care Act: Impact on Providers
Quality vs. Quantity
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Abstract
The Affordable Care Act’s proposal was to make sure that health insurance coverage is
affordable for individuals, families, and businesses and decrease the amount of uninsured
individuals. . Much of the impact of this act will begin when the major coverage provisions take
effect in 2014. Providers will experience an increased burden in many aspects of their medical
profession including new legal practicing liabilities, less autonomy, administrative
encumbrances, shortages of primary care physicians, and political infringement (Horton, Hollier
2012). The provider is to maintain high quality of care while the ACA’s agenda is cost and
quantity over quality.
The Affordable Care Act is the largest piece of legislative reform in American history
relating to health care. The impact to our economy on many levels of scale and our constitutional
rights are all being questioned and debated without a definitive answer to long term reality of its
implications. Reform is necessitous to the continuance of providing care, controlling fraudulent
activities and waste, as well as, exploring new innovative ways to maintain a high level of
quality services within the legalities of our legislative branch. The balance of these aspects have
been challenging and perplexing in materializing the reforms into fruition. The concentration
during reform has been on quantity of the insured population, effects on businesses as in tax
benefits, taxation, and the CMS. The ACA, legislatively is in the beginning stages to reform
health care. Thus far the application of reform are in disarray as it is on the operating table cut
wide open and bleeding out, without a surgeon in the room. The complexity has the medical
society and American constituents confused and anxious of its impact. Providers have great
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apprehension of more government intervention, less reimbursement and incentives for Medicaid
and more red tape. The expectations of flooding the providers with millions of newly insured
has profound implications. The burden of administrative encumbrances, shortages of physicians,
more government intervention, less autonomy and new legal practicing liabilities will affect the
quality of care at its heart.
A doctor of medicine is to date referred to as a provider. The categorical job description
has impacted the art of medicine in the public’s eye. The term provider devalues the medical
professional, whereby preparing the industry to become regulated and physicians to be humbled.
“The legal system determines health care and the focus is on quality, regardless of cost” (Horton,
Hollier, 2012).
“I will remember that there is art to medicine as well as science, and that warmth,
sympathy, and understanding may outweigh the surgeons’ knife or the chemist
drug”(Lasagna, 1964,modern, para. 2).
The modern Hippocratic Oath has not changed dramatically from when it was first written by
Hippocrates, to bind the privacy of patients, the obligations to society and the responsibility of
providing care and prevention. However, the how of applying their Oath in regards to the job
description of physicians is evolving. “Ultimately under the ACA, physicians carry the legal
burden. Physicians cannot follow the new legislation’s pronouncements to reduce health care
costs in the face of a legal system that demands they practice excessive-cost care”(Horton,
Hollier, 2012). The consequences of physicians facing the changes of cost effectiveness through
legislation and the legality of the practice and what is required can lead to ethical decision
conflicts, fraudulent practices, and inappropriate outcomes. The legal system requires that
physicians meet the standard of care otherwise they are negligent. (Horton, 2012) The requisite
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standard of care is determined by evaluating the performance and abilities of a doctor’s practices
by means of their peers. The standard of care is upheld in the court system publically through
jurors and professionally within the scope of fellow physicians. To err is human, to err as a
physician is malpractice. The ACA did not attempt to reform or examine any possible tort reform
or proposals for change within medical malpractice. Government is strangling medicine with
regulations and federal mandates thus far, but not re-evaluating the legal system to whom
standards are set. When taking into consideration the cost of health care, how much of the cost
is from the ceaseless taxations with government intervention? A balance needs to be created
between quality of care and cost effective care and as of yet the ACA has failed to do so. Cost –
effective care and Quality can become a reality through innnovation, medical reasearch, legal
and regulation reform (Kauffman,p5). Reasearch reduces cost through knowledge and provides
unremitting modifications to a healthier long term patient outcome. The legal and regulation
reform are crucial for provider and health insurance companies in forward thinking to
evolutionize the medical industry. Providers concerns of losing the doctor patient relationship
can be enriched through empowering the patient through edification that is diverse and culturally
driven. The Affordable Care Act is positioning its reform to the detriment of doctors in a
financial predicament along with increased demands with lower compensation and burdensome
legality responsibilities.
The Affordable Care Act is placing a financial burden on physicians
administratively with the amount of overhead needed to follow the guidelines for electronic
medical records, staffing to manage patient care , appropriate the billing, coding and collecting of
payers. The EHR, or electronic health records is costly to the physicians. It takes tremendous
time, due to maintenance, data management, and setup. The introduction to new technologies
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conceives a new demand to implement, load data and train staff. Physicians are concerned how
the EHR effects the patient, as it detracts from the personal connection between the doctor and
patient, as physicians are personally connected to a network in place of the patient. The security
of patient records is a large concern for doctors. If hackers can access the Pentagons network,
and the FBI’s, who is to say that private medical records are protected among the network? This
is a concern as physicians are responsible for the privacy of patient information. The cost of
implementation of EHR per provider is approximately $80,000.00 (Bresnick, 2013). Providers
do not have the option to not acquire EHR by 2014 (Bresnick, 2013). “Data is power” when
collected properly and applied privately, however” patients and physicians should own their data,
not the government” (Wax, 2011). Health care providers are not trained experts in data entry,
management, and finance. They are trained to provide care. The incursion of the millions of the
