The following column was published on June 17th, 2012 in the New York Times’ Room for Debate blog.
In this election year, the Supreme Court’s judgment on the Affordable Care Act will be interpreted through a political lens. But the decision will have real-life consequences on patients, whose voice won’t be heard through the ensuing partisan din.
If the individual mandate is struck down, health insurers cannot feasibly offer insurance to all patients unless they charge patients with pre-existing medical conditions significantly more than healthy patients. According to the Congressional Budget Office, the number of Americans remaining uninsured would be 40 percent higher — 16 million people — without the mandate than with it, and insurance premiums would be 15 percent to 20 percent more.
If the rest of the Affordable Care Act stands, coverage would still expand for 17 million Americans, mostly through an expansion of Medicaid.
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If health reform is struck down in its entirety, however, not only would the uninsured lose, so would other constituents with health insurance, like the elderly. One of the unsung benefits of the Affordable Care Act is Medicare’s Annual Well Visit exam, which has been offered since 2011. Thanks to these visits, which I perform everyday in my primary care clinic, I have the opportunity to evaluate seniors for their risk of falling, screen for depression and ensure preventive services like vaccines and cancer screening are adhered to.
Furthermore, health reform has already helped seniors save money. In 2011 alone, nearly 3.6 million Medicare beneficiaries saved $2.1 billion in prescription drug costs. A total repeal of law would not only hurt the uninsured, but would deny seniors benefits they already receive.
There will be no shortage of political opinion once the Supreme Court’s decision is rendered. Striking down all or part of the Affordable Care Act likely won’t affect these politicians or commentators, who are already secure in their health benefits. Our most vulnerable patients, whose voices you won’t hear, stand to lose the most.
Kevin Pho, MD, is a practicing, board-certified internal medicine physician and the founder and editor of KevinMD, which he built from scratch in 2004 to give clinicians and patients a place to be heard. Over two decades, it has become one of the most recognizable physician-led publications in health care, drawing more than 7 million annual page views and over 500,000 followers across social media. He still sees patients in primary care in Nashua, New Hampshire, the practice he says keeps the platform honest.
He is the host of The Podcast by KevinMD, a daily, 15-minute show that has surpassed 2,000 episodes and 2.6 million IAB-certified downloads, featuring physicians, patients, caregivers, founders, and health care leaders in conversation about what they actually see and do. He is also a national media commentator and the coauthor of Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices.
An acclaimed keynote speaker, Kevin speaks nationwide to clinicians and non-clinicians on health care, digital media, physician leadership, and burnout. His signature keynote, “Connect and be heard: Make a difference in health care with social media,” traces his social media journey since 2004 and inspires audiences to strengthen the doctor-patient relationship, make their voices heard in health reform, and turn the tide against clinician burnout. He is the founder of Physician Speaking by KevinMD, a physician-run speakers bureau, and is available for speaking opportunities.
Kevin earned his medical degree from Boston University School of Medicine and completed his internal medicine residency at Boston University Medical Center. The New York Times called KevinMD “a highly-coveted publishing place for doctors and patients,” and Forbes called it a “must-read health blog.” He is an inductee of the Healthcare Internet Hall of Fame, a recipient of the American Medical Writers Association McGovern Award, and a New Hampshire Magazine Top Doctor.
