Fixing the Affordable Care Act

by Dr. Scott Edmonds

Like the tobacco tax and the sugar tax, taxes can be established on other unhealthy foods and beverages as well the purchase and participation in high-risk activities such as motorcycles, jet skis, parachutes and fast cars.

We could also create a health care tax as part of the penalty for speeding, texting while driving, impaired driving or any other activity that jeopardizes public health and safety. This type of tax system would allow our citizens the freedoms to exercise these activities while providing the funds to offset the risk related to the health care required to cover the consequences of these choices and activities…

The first task is to redesign the base coverage or essential elements of the universal package. The current program is too broad. The essential elements need to cover two basic components; primary care (health education, wellness and prevention) and catastrophic care (hospitalization and essential surgery).

The middle ground, doctor visits to treat diagnosed acute medical problems and all the care related to chronic illness can be premium-based and as comprehensive as desired. This is an exact reversal of the current insurance-based system.The primary care piece needs to be the critical component of the basic system, as it will lead to a healthier society and to lower long-term costs.The care delivery model of this type of care needs to be dramatically modified to achieve this goal. The current narrow, primary care physician based program cannot effectively deliver this care. Even with the medical home model and the aggressive use of physician assistants and nurse practitioners, it is not nearly enough resources.

The system needs to empower the ever-growing army of other health care practitioners to be directly involved and responsible for the basic primary care services. This list includes the obvious cast of the licensed health care providers: optometrists, dentists, podiatrists, pharmacists, and chiropractors.

In addition, it needs to include nontraditional resources such as: mental health providers, physical therapists, occupational therapies, athletic trainers and any other providers that interact with the public in some aspect of health education, wellness and prevention

The final piece of the puzzle is again the use of current technology to provide health education and advice. This is the ever popular “Dr. Goggle”. Perhaps short of Dr. Oz or Dr. Phil, this is the most popular and widely used doctor in America. This provider needs to be vetted and credentialed and become an official source of legitimate medical care.This blog represents several substantive, yet “out of the box” concepts and ideas that need to be part of the thinking process to take the next steps in health care reform.Clearly, optometry is part of the answer as noted, but we need to be a part of a sweeping change in the current system.As seasoned primary health care providers, and part of the current package of essential benefits, we need to be part of the process.It is these types of ideas that we need to share with our elected officials rather than our opinion on the current polarizing issues of the day.

Source: BLOG: Fixing the Affordable Care Act