There's no integration, because every hospital
in this area has a different computer system."
What's the alternative?
Our survey responses underscore the diffi-
culty of bridging the gap between recogniz-
ing the various problems associated with
healthcare delivery, both pre- and post-
Obamacare, and knowing how to solve
them.
"I think (the Affordable Care Act) was a
noble and necessary change to the health-
care insurance business," says Dr.
Pomerance. "The only problem is that func-
tionally, it doesn't work. The effort to not
have pre-existing conditions affect getting
insurance was great, but here, too, there
was a bait and switch, because the insur-
ance companies still rate the person, and if
they have a pre-existing condition, the out-
of-pocket and premiums go sky high."
The better solution, says Dr. Pomerance, would have also been
much simpler. "I'm not usually in favor of more regulations, but all we
really needed to do was require the insurance companies to issue
insurance to everybody. What we're doing now is taking insurance
away from somebody so somebody else can have it, and then we're
requiring the people who gave it up to get it again."
Full transparency and patient responsibility would make the needed
difference, says Narayanachar Murali, MD, FACP, FACG, of
Gastroenterology Associates of Orangeburg (S.C.), adding that insur-
ance "muddles" transparency. "The patient is shielded from the cost of
care completely," he says. "That's why the care in this country is so
5 1
M A R C H 2 0 1 5 | O U T P A T I E N TS U R G E R Y. N E T
"The patient is shielded
from the cost of care
completely. That's why
the care in this country
is so unaffordable. And
the ACA has made it
unaffordable for every-
body."
— Narayanachar Murali,
MD, FACP, FACG
