Local Doctors Have Mixed Feelings About Health Care Legislation

The sweeping health care bill that President Obama signed into law this month was lauded by most Democrats as historic, but Republican representatives voted against the bill due to its hefty price tag and mandates for increased government oversight.

The Congressional Budget Office estimates that the Patient Protection and Affordable Care Act will cost $940 billion in the first decade of its enactment.

New York Senators Chuck Schumer and Kirsten Gillibrand both voted in favor of the bill. House Representative Nita Lowey (D-Harrison) also voted in support of the measure.

"This bill will give all Americans the same health insurance options as members of Congress, while reigning in the most egregious practices of the insurance industry and strengthening Medicare," Lowey said.

While some local doctors have supported the legislation for mandating affordable health care coverage for all Americans, they're also concerned that it doesn't adequately address many key issues.

Dr. Michael Suzman, a plastic surgeon with WESTMED in Rye, said that he anticipates that the bill will provide health insurance to those currently unable to access it affordably.

"I would hope that this bill provides access to care for some patients who haven't had easy access," Suzman said. "We're fortunate in the Westchester area that the majority of residents have access to health care and health insurance."

According to the U.S. Census Bureau, 79.4 percent of Westchester residents between the ages of 18 and 64 had health insurance coverage in 2006.

While about half of Suzman's patients visit him for cosmetic surgeries, which aren't usually covered by insurance, he noted that the legislation could provide important coverage for people needing reconstructive surgeries.

"I hope expanding coverage will allow more people in need of reconstructive plastic surgery to get care for serious conditions such as injuries, accidents and cancer," he said.

Local doctors are also concerned about how lawmakers will implement the legislation.

Dr. Peter Maro Jr., of Blue Wave Orthodontics in Rye, said that he didn't know enough about the bill to anticipate its effects, but also said that since most of his patients pay out-of-pocket and are later reimbursed by their insurance companies, the bill wouldn't likely have a drastic effect on his office.

However, Maro noted that he pays for his own employees' health insurance and if the bill mandates an increase in costs for him, he said, "I'm just going to dump them on the government plan."

Perhaps the most widespread concern amongst physicians is that there was no inclusion of tort reform in the legislation.

Last December, the Westchester Medical Association dissented against both the Senate and House versions of the bill because neither addressed the costs physicians associate with protecting themselves against often frivolous lawsuits and hefty legal fees.

In a letter to the group's members, President John Stengel said the WMA supports "efforts to expand health insurance coverage for Americans" but "any meaningful health care proposal must include tort reform to eliminate the waste inherent in our current 'defensive medicine climate.'"

Dr. Nancy Beran, Medical Director of Westchester Health Associates, said that one of the major drawbacks of the bill is its lack of tort reform initiatives.

"We need tort reform and we need it now. If somebody can still sue every time they have a bad outcome, you're going to continue driving up the cost of medicine."

Beran also said that high malpractice insurance premiums can drive doctors out of their practices. Without legislation that addresses burdensome malpractice costs, Beran believes that a larger goal of providing outcome-based care—which is more focused on patient behavior than on scientific evidence—will be difficult to achieve.

"If we're trying to shift the paradigm to outcome-based care, we really need to support physicians to do that," she said.

Lowey said in recent statement that the bill leaves tort reform up to states:

"Medical malpractice insurance should not be prohibitively expensive, and frivolous lawsuits must be stopped so that doctors can give patients the best care instead of practicing defensive medicine," she said. "I am pleased the health insurance reform law encourages states to develop malpractice systems that protect doctors from frivolous lawsuits and protect patients' rights."