It would be hard to imagine that anyone at University Hospital didn’t hear the news yesterday that the US Supreme Court upheld the Affordable Care Act, also known as “Obama Care”. This is an important milestone for the country, and in particular for the patients that we serve everyday at University Hospital.
We are all too familiar with many of the problems in our current healthcare system. As the region’s largest healthcare facility, we provide a disproportionate share of the care to the uninsured and the underinsured in Central New York. We frequently see the outcome from individuals who have had no access to primary care, and thus wait until they are truly sick before seeking care. We regularly see the results of lack of access to preventive care. Caring for such individuals is part of the noble and broad geographic mission of the Upstate Medical University and University Hospital.
It is certainly my hope, shared by many, that the Affordable Care Act will help to improve healthcare in the United States. The ability to ensure healthcare coverage for more of the US population is really the cornerstone of this important act. There are many other positive benefits including: the end to coverage denials for pre-existing conditions, the end to lifetime caps on insurance, the ability to allow young adults to continue to be insured on their parent’s health insurance premium, the promotion of prevention and wellness care, and initiatives to promote innovation in the way we deliver healthcare.
However, the Affordable Care Act also creates some concern for Academic Medical Centers like Upstate. Over time, we will potentially lose payment from the federal government for care of the uninsured and underinsured through the Disproportionate Share Program (DSH). This is a significant income stream to University Hospital. We remain concerned about the loss of dollars to help support our Graduate Medical Education (GME) programs. This is the training pipeline for the future healthcare workforce. We also remain concerned about the state’s commitment to expanding the Medicaid program through the Affordable Care Act at a time of serious state fiscal restraint.
The decision by the court to uphold the Affordable Care Act will certainly unleash a firestorm of political rhetoric, partisan bickering, and misrepresentation of the facts surrounding this important piece of legislation. As providers in an academic medical center, we should all be pleased that more and more of the population could be served by the high quality employees and providers of an institution like University Hospital. We should look forward to serving a broader population and to providing a broader range of services. This landmark decision, however, will change the way many citizens approach healthcare and we as an institution and as individuals need to be prepared to change with the times in order to meet the upcoming challenges to the healthcare system, to University Hospital, and to our patients.