Samadi's Take on Supreme Court Ruling for Obamacare: Patients and Doctors are Left Confused

 This morning, the Supreme Court ruled in favor, with a 6-3 decision, to uphold the Obamacare authorization of federal tax credits for eligible Americans living not only in states with their own exchanges but also in the 34 states with federal exchanges.   

How did this all begin? The case, King v. Burwell, debated whether or the not the Obama Administration ignored aspects of the law regarding provided taxpayer-funded subsidies to Obamacare purchasers in all 50 states, when the law stated this could only happen in the few states that had set up their own exchange. It’s all quite technical, but the main point is upholding Obamacare further confuses doctors and patients, and we’re left with many other issues that haven’t been firmly addressed.

I advocate for my patients every day and I see their frustration and confusion when it comes to their actual coverage under Obamacare as well as the higher deductible.  As a specialist in the field of prostate cancer, I observe three major issues with Obamacare.

1.      Narrow Networks: What many patients are unaware of (often until the last minute, or a serious need has arisen) is the massive limitation to the number of doctors, specifically specialists, they are “covered” under. Arguably, patients may find they have no access to the most experienced doctors and surgeons in their respective fields. If you’re someone diagnosed with Prostate Cancer or any cancer, you want the best care and to be in the best hands. Imagine if your insurance limits you from seeing the expert? Obamacare has put into effect extremely narrow networks of doctors, patients have access too, which leads to the question: Is this denying the freedom the patient’s right to choose their own doctor or specialist? The reality is, not every doctor or specialist is going to take every insurance under the sun. With these limitations, Obamacare diminishes the value of experts across many fields.

2.      Satisfaction Survey Scores Puts Pressure on Doctors: One of the major issues with regards to Obamacare mandates is the pressure put on hospitals from Medicare, specifically for patient satisfaction surveys. Now, it’s important for me to note that I appreciate all the feedback, good or bad, that my patients give me. It’s not specifically about the direct feedback; it’s about the penalties and variables that affect the patient’s actual survey answers, and the timing of when they’re presented with these surveys. Imagine, you’ve just had surgery, you’re in pain and you ask your surgeon for pain medications. Based on your surgeon’s experience and judgment, he or she believes it’s not the best medication for you at that moment in the process. As the patient, you feel frustrated and then you’re handed a survey. You haven’t even gone through the entire process to full recovery and in that moment you’re expected to judge all the healthcare professionals you’ve worked with. The art of medicine is compromised. I always say, the PSA blood test for Prostate Cancer screening is only as good as the doctor evaluating it. Doctors need to be able to work one-on-one with their patients, without the added pressure of survey scores and ratings that have little insight into the entire patient experience.

3.      Quality of Care Rating: The fact is you cannot put a number on quality of care. There are far too many factors and variables that affect one patient’s experience and the quality of care they received from another. The 1-5 star rating mandate from Medicare based on patient satisfaction scores —which stemmed from Obamacare — in April is a cause for concern because hospitals are massive entities. How is it possible to slap a one-digit number on the front door of a hospital, which sums up the rating for the work of thousands of healthcare professionals, along with millions of varied patient cases? It’s simple, we can’t.