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http://www.medscape.com/viewarticle/719014_7
This is a 7 part discussion. All parts are at the site. The conclusion follows.


What Does the Healthcare Reform Bill Really Mean for Doctors?: Prevention and Wellness


Prevention and Wellness

Many politicians have said that keeping patients healthy through prevention education will be important as far as keeping healthcare costs low.

Where's the beef?

The legislation contains no financial incentives directed at patients to encourage them to lower their cholesterol, quit smoking, lose weight, or in other ways to take responsibility for their health. At the moment, responsibility rests with public education programs and with physicians who are supposed to motivate patients. The patient has little financial incentive to be a collaborator.

"It will be interesting to see what plays out," says Ahlborn.

PROS

Social welfare -- more Americans will have access to health insurance, including patients with preexisting conditions who could not get coverage previously.

Primary care doctors and pediatricians who currently contract with lower-than-Medicare-rate insurers can see new Medicaid patients at Medicare reimbursement rates.

Hospitals and the physicians who work in hospitals may receive more payment from newly insured patients rather being unpaid for charity care.


Potential new business opportunities exist for primary care doctors to practice in inner-city areas or locations where previously there were not many insured patients.


More money will go toward training in medical schools to increase the number of primary care doctors.



Business expansion is possible for doctors willing to hire more PAs and NPs to see more patients.



CONS

Many say that the new budget cannot ultimately fund the healthcare reform. Money may have to come from additional taxes or some cuts to physician payments.

A 3.8% tax will be levied on unearned income (ie, interest income and capital gains) for individuals earning over $200,000 ($250,000 for married couples). Many doctors are in that category.

For specialists, reimbursements for the newly insured Medicaid payments will not be raised to Medicare levels.

There is no tort reform provision, which will keep doctors practicing defensive medicine.

Cost-containment measures are not included.


There are no incentives for patients to have accountability for their healthcare improvement or to maintain wellness.
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