I am writing in reference to Mr. Runnels’ article “ACA impacts local insurers, doctors,” in the Marysville Journal-Tribune on May 4. It is their discussion that I would like to offer my thoughts, in the hope that it will add clarity.
Dr. Davis, interviewed in the article, as a cardiologist spcialized in vascular medicine at E.P.I., Electrophysiologist, Pacing and Inverventionalists. E.P.I. is a full-service private cardiology practice providing cardiology, electrophysiology and vascular medicine services.
The points of clarity I hope to make are, the ACA was a tax placed on young and insured people to pay for the uninsured. This cost shifting from hospitals and government sources is reflected by higher premiums and out-of-pocket costs. These populations find themselves financially worse off with respect to health care cost and access. With fewer people than estimated participating in the insurance pool, further increases the burdens to these populations.
The comments of Ms. Reser as justification for the higher reimbursement afforded hospitals compared with the private setting, leaves the impression that quality is indeed better because of the of the certification the hospital maintains. These certifications evaluate providers’ testing centers to assure testing is done with reasonable technology, patient safety and for accurate and timely data reporting. Your readers should know that these same certifications are maintained by most private practices. E.P.I. has maintained certification since its founding in 2002, preceding certifications of several hospitals in the Columbus area. Certification in private practice was important to avoid any implications of substandard quality and insurance companies require certifications for reimbursement of office based testing. In a well-run practice, there would be no difference in quality.
My final point of clarity to Ms. Reser’s reasoning as further justification, was the cost of uncompensated care, technology and human resources. The delivery of health care is costly, even well-run private practices have a 70 percent fixed overhead, but no one is calling for rent freezes, employee salary or benefit reductions, not even tax relief for private practice physicians.
Senator Rand Paul did put forth a suggestion that physicians be able to write off uncompensated care on taxes. Hospitals already have this relief. The ACA decreased the uncompensated care gap for hospitals while widening it for private practices. The higher out-of-pocket costs results in decreased total payments to physicians, as well as well as delay of the payments they receive. It further increases the cost of collections in the office setting where resources are already tight. Hospitals obvious advantages have driven physicians to join corporate medicine more than any other factor.
I believe it is unproductive to pit private practice against hospitals, but this is the outcome of the acceleration of the “business of medicine.” What is lost is the “physician, patient relationship.”
Vincent L. Guinn,
President and CEO of E.P.I.
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