Friday, July 6, 2012

Are We Celebrating Healthcare Too Early?

Last week, the news broke that the Supreme Court of theUnites States (SCOTUS) upheld the individual mandate, and the constitutionality of the Affordable Care Act (ACA). Initially, health experts were happy to see advances being made in improving our country’s health care systems. Now, many of those experts are beginning to question just how large that victory was.

Fierce Healthcare editor Karen Cheung has been writing about healthcare for a long time, and in her column this week, she expresses some reservations about President Obama’s victory.

 Even though many patients and providers breathed a sigh of relief last week when the Supreme Court ruled that the Affordable Care Act is constitutional, they're still keeping their fingers crossed when it comes to overuse and overcrowding in the emergency room.

According to the American College of Emergency Physicians, ER visits will continue to rise, regardless of the ruling… With half of health leaders reporting that their emergency departments are overcrowded as is and overcrowding growing twice as fast as ER visits, it's grim news for hospitals, still struggling with the ever-growing ER problem.

Cheung worries that the ACA is asking emergency rooms to do more with less, and that reduced staffing and resources will add to the overcrowding issue. The Washington Post reports on a similar problem, in which the law will likely cause negative side effects in other, similar companies.

Many [insurers] may see profits margins shrink because they will no longer be able to deny individuals with pre-existing conditions. At the same time, the law limits how much insurers can raise their rates — if they go over a certain percentage, they’ll have to rebate consumers…

… Mom-and-pop nursing homes and other small long-term care facilities may struggle to stay independent because they won’t be able to afford the costs of complying with new regulations. “We’ll see an increasing consolidation of the long-term care industry, especially as baby boomers get older and start to require care,” said Michael Loucks, a health care attorney at Skadden Arps.

What do you think? Do the pros out-weigh the cons? Have we overestimated the help that the ACA can bring? Tell us in the comments!


Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at

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