RRH CEO discusses Affordable Care Act

Linda Saholt

News Review Correspondent

More than seven million Americans have signed up for health plans under the Health Care Reform or Patient Protection and Affordable Care Act (“Obamacare”), according to an April 2 Internet story attributed to the Washington Post.

Signed into law on March 23, 2010, the act has provisions for phasing in reforms and changes up until 2022.

James Suver, CEO of Ridgecrest Regional Hospital, spoke about how the ACA is affecting health care locally.

“The Affordable Care Act probably doesn’t impact the average person initially. Some people were affected who lost private insurance that didn’t meet the new standards,” he said.

“What might happen is that the average person may experience longer delays in treatment and even in emergency-room treatment, because people who didn’t have insurance now have insurance. Also, there is an acute physician shortage, not just here, but all over. That will take about 10 years to work out, because it takes that long to get grad students through the requirements to be ready to practice.”

What about those on Medicare? “They may also see enhanced wait times,” said Suver. “Many Medicare patients have supplemental insurance. The future of supplemental insurance is uncertain, due to Health Care Reform. That may not be this year, but it’s being discussed for the future.”

How will this act affect those who already have health insurance? “Some people lost their private insurance plans because the plans didn’t meet the new standards. It looks like premiums are going to go up more than we would expect from inflation,” he said.

“Another long-range answer is, by about 2017, we may see fewer employers offering their employees health insurance. They may instead give their employees a stipend to buy their insurance under the Insurance Exchange.”

For those interested in the California insurance exchange, see www.healthexchange.ca.gov. This is an independent public entity within the California state government, with a five-person board appointed by the governor and legislature. The purpose is to make it easier for people to compare insurance plans and buy health insurance on the private market.

Apparently one unexpected trend was thatose people signing up for healthcare exchanges under Health Care Reform tend to be older and sicker than was projected. “They’re mostly in their 40s and 50s. The program needs more young, healthy people to balance it out. Since the older members will be heavier utilizers, the cost of those plans will be higher, which means those costs will be passed on to those with commercial insurance,” said Suver.

How will the system work? “For most people, it will work the same way, even if they are covered under the insurance exchange, because they will have an insurance card and for us, it’s one insurance versus another,” he said.

“The biggest change, though, is that there will be more incentives for providers, such as doctors and hospitals, to keep patients well, as opposed to treating them only when they’re sick. This will be a good thing. It will help move medicine from a sickness model to a wellness model. It’s exciting to me, but it will be a huge change to the health care system.

“We will be putting a lot more focus on keeping people well, on preventive medicine. The focus will be back on the patients. For example, if you are a smoker, there will be lots more emphasis on giving you information on how to quit smoking. If you’re obese, there will be a lot more focus on getting the pounds off to prevent diabetes. Hopefully, making the patient more accountable for staying well will encourage people to keep themselves well.”

What changes will patients see? “There are some exciting things about healthcare Reform. I think it will take at least 10 years to get all the bugs out of the system,” he said. “It’s going to be interesting to see how it works. This is probably the biggest change in health care since Medicare and Medicaid were passed in 1965.”

For more information on Ridgecrest Regional Hospital, see www.rrh.org.

Story First Published: 2014-04-09