I believe that the Patient Protection and Affordable Care Act (PPACA), recently upheld by the Supreme Court, will be good for the vast majority of Americans because it imposes health insurance reform that will result in more health related spending on actual patient care and less in profits to insurance companies. Everyone talks about how America spends 18% of its GDP on health care but this is a very misleading statistic because the vast majority of that money actually ends up in the pockets of executives and other stockholders of our Nation's public and private insurance companies. Somehow health insurers have managed to hide the true medical loss ratio (portion of premium dollars spent on actual patient care) from public attention for decades as a result of very sophisticated "nut shell" game. In my years of experience and in negotiating health insurance company contracts through third party administrators, I have become aware of the true medical loss ratios for insurers and they are typically around 50% of the premium dollars they collect. Simply put, 50 cents of every dollar they collect is paid out in claims. One of the most important requirements of the PPACA is to mandate 80-85% of every premium dollar is spent on patient care or quality improvement(ambiguous). This is certainly a change for the better for Americans and I support it. See this site for more details http://www.healthcare.gov/news/factsheets/2010/11/medical-loss-ratio.html
In addition to the reform on health insurance company pilfering, the PPACA will attempt to enlarge the insurance risk pools to include coverage of the healthy, low risk population which should make insurance for the high risk, sick and elderly more affordable by spreading the cost of healthcare over a larger population of premium paying beneficiaries. I believe everyone deserves exceptional healthcare as a basic human right and I believe that is also how the President saw it when his Administration drafted this legislation. By restoring and preserving health to all Americans, we as a Nation can focus on working together to bring our Nation back to its greatness in the eyes of our countrymen and other nations.
Back and neck pain are the most common disorders affecting the spine. Spine surgeons play a key role is shaping the care of patients suffering with degenerative and traumatic spinal conditions including chronic back and neck pain. If the correct diagnoses are made as to the cause of the pain and a properly executed treatment is rendered, 90%+ of back and neck pain can be cured. Yes, I said cured. Chronic back and neck pain patients live tortured lives and if they are not fortunate enough to "find" a physician that understands the causes of their pain as well as how to cure it, their suffering will endure...needlessly. The only other significant barrier to curing chronic back and neck pain aside from an incorrect diagnosis or an improperly executed "correct treatment" is denial of care by the patient's health insurer. Unfortunately, the PPACA does nothing to stop the insurers from adding more tests, medications or treatments to their lists of "medically unnecessary" or "experimental" care. Every doctor has encountered these denials on a daily basis in their practice and the insurers have successfully driven a massive wedge between the doctor patient relationship, effectively destroying it. Insurers have exploited this avenue of cost savings that goes unchecked and unregulated while doctors are powerless to fight for their patients' rights without engaging in an elaborate, complex and usually futile scheme called the "appeals process". I only hope future legislation will be enacted to return the control of medical care back to the patient and their physician.
Ara J. Deukmedjian, MD
Board Certified Neuro-Spine Surgeon
Associate Professor of Neurosurgery, UCF College of Medicine
Chair, Surgery Department, Parrish Medical Center
President, Brevard County Medical Society
CEO and Medical Director, Deuk Spine Institute