Few issues in healthcare are more polarizing than the Patient Protection and Affordable Care Act, and discussion of President Obama's law made for one of the most invigorating and spirited debates at the Becker's Hospital Review 5th Annual Meeting in Chicago on May 16.
Journalist Forrest Sawyer moderated a panel discussion with three hospital health system executives — Barry Arbuckle, PhD, president and CEO of MemorialCare Health System in Fountain Valley, Calif.; Teri Fontenot, president and CEO of Woman's Hospital in Baton Rouge, La.; and Ora Pescovitz, MD, CEO of University of Michigan Health System in Ann Arbor — centered around the PPACA, what it does well and what more needs to be done.
Dr. Pescovitz, a pediatrician, said she supports many parts of the PPACA, especially Medicaid expansion. Michigan, led by Republican Gov. Rick Snyder, bucked the conservative trend by expanding the health insurance program for the poor. She said it was "incomprehensible" that other state governments were unwilling to take federal dollars to expand Medicaid.
"In this case, it was something that benefited not only the entire citizenry, but all our hospitals together," Dr. Pescovitz said. "I think it's quite clear that patient care is markedly better when care is given across continuum."
Ms. Fontenot, however, said she was not sold on Medicaid expansion. Louisiana has not expanded the program. Her hospital, a specialty hospital for women and children, already receives high volumes of Medicaid, and thus the expansion likely wouldn't affect her hospital much. But she also believes nationwide, Medicaid expansion is not a panacea. "Just because you expand coverage to an uninsured person does not mean they have access," she said.
Dr. Arbuckle said he supported some parts of the law, especially the fact that the government is attempting to deal with the problem of the uninsured. "That's simply not right," he said, noting how millions of Americans have suffered without health coverage. However, Dr. Arbuckle said he believes other parts of the law appear to be unsustainable, like the built-in cuts to hospital Medicare reimbursements. He said he's concerned about how "Medicare Part A is used as a piggy bank to solve our fiscal problems."
"Medicare in its current form cannot survive," Dr. Arbuckle said.
He also said healthcare reform is encouraging more providers to consolidate, but hospitals and physicians cannot "stop short of integration."
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