Do not confuse ‘Obamacare’ with health care reform

ByScott A. Edmonds, OD, FAAO

I was speaking to one of my colleagues about my thoughts on the role of optometry in health care reform and was surprised to hear her express the opinion that, “All this health care reform talk is a waste of time because Obamacare is going to be repealed as soon as the next election cycle is complete.”

The rousing nodding of heads around the group of other colleagues led me to believe that there is a fundamental lack of understanding about health care reform among at least optometrists, but probably among most health care professionals.

Health care reform is a general term used by many in the public health arena to meet the following goals:

broaden the population that receives health care coverage through either public sector insurance programs or private sector insurance companies
expand the array of health care providers from which consumers may choose
improve the access to health care specialists
improve the quality of health care
give more care to citizens
decrease the cost of health care

The term is often used when examining the American health care system because America is world’s largest country in need of health care reform. Although American doctors represent some of the most outstanding and innovative health care leaders in the world, the system where we provide day-to-day care is weak, confusing and terribly inefficient. To oversimplify yet sum up the American health care problem: The people who need it can’t afford it, and the ones that can afford it don’t need it. This point becomes clearer when we examine some recent statistics:

Health care in the U.S. ranks lowest among developed countries (British Medical Journal, 2008).
The mixed public-private health care in the U.S. is the most expensive in the world (World Health Organization, 2009).
In 2011, 48.6 million people in the U.S. (15.7% of the population) were without health insurance (U.S. Census Bureau, 2011).

Health care reform was in action long before Obamacare and will continue with or without that particular law.

Examples of health care reform include:

optometric parity under Medicare
HMOs (health maintenance organizations)
the RBRVS (resource-based relative value system)
HIPAA (Health Insurance Portability and Accountability Act) requirements
PQRI (Physician Quality Reporting Initiative) and PQRS (Physician Quality Reporting System) codes
electronic health records and meaningful use

Although one can relate the two issues and say that Obamacare has rapidly accelerated health care reform, the two terms are not synonymous.

If one examines the goals of the entire health care reform movement as listed above, it is easy to see how optometry can take a major role in this effort. The steps to help optometrists embrace a role where they become more involved with systemic medical care, as highlighted in this blog, are also consistent with the movement.

Optometrists, perhaps more than any other health care provider, can be a major player in improving the American health care system. Optometrists see many patients with refractive errors who consider themselves “healthy” and do not see any other health care provider. Often these patients smoke, are overweight or have a bad family history. If optometrists can collect vital signs on these patients, transfer the data to the primary care physician and provide appropriate health education and counseling, they will be addressing goals 1, 2, 4, 5 and 6 of health care reform.