by Loren Bonner
, DOTmed News Online Editor
President Obama's re-election, coupled with strong Democratic support in Congress, has health care reform on a path forward toward full implementation by 2014.
In the October issue of the Journal of the American College of Radiology, Dr. Frank Lexa, a professor in the department of radiologic sciences at Drexel University in Philadelphia, argued that the results of the presidential election and health care reform's fate will have a significant impact on the future practice of radiology.
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"If it follows the path of state-level reforms in Massachusetts, on which PPACA was modeled, radiologists should expect health care costs to continue to rise, prompting a push for increased revenues and alternative models of reimbursement not based on fee-for-service," Lexa said in the article.
In other words, lower reimbursement and more federal control over the use of advanced imaging in clinical practice.
I caught up with Lexa and asked him to explain what he means in more detail. Here's an edited version of our conversation.
Overall, what does Obama's re-election and the continuation of the implementation of health care reform mean for the future of radiology?
The biggest news from the election for me is if you look where we'll be on Jan. 20, 2013, it will look like what things have looked like over the last two years. We'll have the same president, a Senate controlled by Democrats and a House controlled by Republicans, which is where we are now. You can expect a continued attempt from the White House to stay on the path and follow the trajectory in the health care bill. The president has said all along — going back to the time before the Supreme Court's decision — that he's very determined to do this [health reform] and he's not going to give up. He made a comment that if the Supreme Court had knocked it down, he would just start over again. Of course with an opposition in the House, they will do what they can to try to modify the implementation of the bill, but with a president that doesn't have to get elected again, I would suspect that he'll want this to be his signature piece for what his legacy will be. I don't see him giving up on it the way other presidents have. He's going to try to implement the plan along the lines he talked about. You have a status quo basically.
What does this mean for radiologists?
Certainly the bill has not been kind to us, and the ethos in the bill is very much a transfer of power from practitioners to hospital entities but also from specialists to primary care doctors. That's not a secret. It's clearly in the bill — putting more money in the hands of primary care. Certainly one of the worries I would have for the future of U.S. medicine is whether or not we are going to hurt some of the things we do best, which is cancer care, care for premature babies and trauma victims and things that require high-level care and multi-specialty facilities. And that's work we're respected for around the world.
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