What's clear is that the re-election of President Obama ensures the ongoing implementation of the Affordable Care Act (ACA). Some of that is good (elimination of pre-existing condition exclusions, elimination of lifetime benefit caps, inclusion of tens of millions of people into the health care system), and some of that is bad (the unchecked power of the Independent Payment Advisory Board, the uncertainly around guaranteed benefits in state health exchanges, and declining physician reimbursements).
What's unclear is how the ACA can simultaneously expand access to care for millions of people while purportedly controlling costs. It seems that to significantly control costs, something has to give. Will they reduce physician reimbursement? No one seems to be in any hurry to scrap the flawed Medicare Sustainable Growth Rate, which means Medicare reimbursement will decline 27 percent next year. Will they cut costs for drugs, devices and hospital care? Those things are clearly on the chopping block.
In the short term, the device tax and the implementation of the Independent Payment Advisory Board will adversely impact investment into innovative technologies, and likely curtail physician reimbursement. Those two elements do not bode well for spine surgeons and their patients. Our organization - International Advocates for Spine Patients - remains vigilant to ensure that implementation of the ACA does not unnecessarily restrict patient access to medically indicated spine surgeries, nor unduly dis-incentivize investment in innovative and life-improving medical technologies.
Thomas Errico, MD
Chairman of the Board