Problems with the Affordable Care Act (ACA), or Obamacare, include a lack of physician input, no mechanism for controlling costs, and widening the relationship gap between the doctor and patient.
Dr. Kris Smith spoke to me about the need for health reform. He practices with Barrow Neurological Associates in Phoenix, Arizona, and says the ACA leads to more insurance company involvement, places greater stipulations on physicians, and increases the complexity of practicing medicine.
Dr. Smith is the author of It's Not Brain Surgery, A Neurosurgeon's Prescription for Health Care Reform. In his book, he takes the reader through the history of health care including President Franklin Roosevelt's attempt to nationalize health care and physicians rebelling.
He says health practitioners wanted to be able to price services and care based on a patient's income.
Older readers may remember doctors making house calls and having a sliding scale for patients, but the third-party payer system has taken away personal responsibility for health care spending and has led to an upswing in costs.
Dr. Smith says the real cost of treatment is hidden and in his book says patients face a "trumped-up charge to a third-party payer justified by medical liability coverage."
Dr. Smith calls for "a bona fide two-tier health-care system in the U.S., somewhat similar to Australia" and describes how that can function.
He says the current dilemma is the opposite of service-oriented medicine with "public dollars utilized for and attempt to pay for the same level of care as those in the private system."
I asked if he felt a "black market" would emerge in health care.
"I would call it alternative payment systems, the concierge medical services for people who can afford it and want a more personalized service." Dr. Smith said employer-based health coverage is a reason people now have no say in their health care. "Your employer will sign a contract with the lowest bidder. Once you need specialty care the best doctors are not on your plan."
Glaring Omission from Obamacare
Dr. Smith says liability reform is ignored in the Affordable Care Act. He wrote a chapter titled "Medical Malpractice Challenges" and says too many people are conditioned by movies and television to believe that cures exist for all ailments. If a patient dies, it must be the doctor's fault.
"Lawsuit abuse is the most important problem to correct in order to curtail the cost of health care in America," he writes.
Dr. Smith's specialty is the comprehensive management of brain tumors and the surgical treatment of epilepsy.
Click here for the book's website through the publisher or visit Amazon for a complete description.