Health Care “Exchanges” Are a Reform We Can Support

bio-greenPeople are often surprised to hear that I care about the discussions going on in Washington DC and in Olympia regarding health care insurance reform. What difference does that make to a plastic surgeon?

Well, as it turns out, plastic surgeons care a great deal about access to health care coverage, as much of our work is reconstructive in nature rather than only cosmetic. Insurance companies and the federal government foot the bill for these types of services. For me personally, about 60% of my day is spent on reconstructive plastic surgery. This would include things like skin cancer screening and removal, hand surgery (carpal tunnel syndrome, arthritis, tendonitis and other injuries), breast reduction or reconstruction, scar revisions and wound management. This variety is, in fact, one of the things I like best about my job.

Most doctors in the United States remain unclear about what exactly heath insurance reform will
mean for them. Primary care doctors in many areas find themselves tremendously overworked and therefore unable to accept new patients, especially if they are covered by Medicare or Medicaid. Thus, problems with access to health care may continue to exist even after the health care “reforms” are fully implemented in 2014. Medicare and Medicaid simply do not reimburse hospitals and doctors enough to cover the actual cost of providing health care services to patients covered by this type of insurance. Washington State plans to greatly expand the number of its citizens covered by Medicaid. Will this increase access to care for these patients? That remains to be seen.

As an employer in a small business, I am looking forward to the ability to purchase health insurance for my family and for my employees on health insurance “exchanges” that may be available across state lines. Currently, we may only purchase coverage in the state of Washington and may not band together with other small businesses. This makes the cost of insurance very expensive, especially as we all age (I am “celebrating” one of those decade birthdays myself this year). This may be the one reform which truly helps the 70% of Americans who work in small business.