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I'm Not a Doctor

A second opinion on the challenges and opportunities facing today's physicians.
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By Andis Robeznieks

Ohio docs group looks to keep the health reform debate rolling

Stating that "Ohio is a battleground state and healthcare is a battleground issue" in the upcoming presidential election, the president of the Ohio State Medical Association said his organization is pushing to have President Barack Obama and his presumptive Republican challenger, Mitt Romney, hold a debate on healthcare issues in Ohio.

"We challenge them to have a debate just on healthcare, and we'd be happy to help organize it in the state of Ohio," said Dr. Deepak Kumar, president of the OSMA.

For Kumar, a Dayton-based colon and rectal surgeon, the healthcare reform fight is not over despite the U.S. Supreme Court ruling to uphold the Patient Protection and Affordable Care Act.

"The president had a great opportunity to make a real great change in healthcare, but he fumbled it," Kumar said. "Now we are going to have to spend time and resources to fix it."

The Ohio physicians group says it likes the law's focus on prevention and wellness, doesn't like that it doesn't include a replacement for the sustainable growth-rate formula for Medicare payment and believes that there must be better ways to provide access than to rely on "underfunded and overstressed public programs" such as Medicaid.

Kumar said his organization opposed the law because it had more negative than positive aspects.

"That was our position from day one," said Kumar, a Dayton-based colon and rectal surgeon. "Our position is essentially the same."

Kumar said problems with the law also include that it lacks comprehensive tort reform, and he said the OSMA is also looking to repeal the section of the law that established the Independent Payment Advisory Board cost-control panel.

If physicians are held liable for an individual's heath, Kumar said, patients should be subject to some type of individual-responsibility provision that would penalize them if they fail to act in the best interests of their health. For example, if a patient refuses to take advantage of free or discounted preventive medicine or wellness services, Kumar said, he or she should face higher copayments or the loss of some benefits.

Kumar added that although he welcomes provisions for higher Medicaid payments and expansion of eligibility, he's concerned about the program's viability. "You can't put a second story on a house where the first story is crumbling," he said.

Kumar described Medicaid payment rates as "pitiful" and noted that they don't cover the cost of providing care.

"If I had to rely on Medicaid, I could not stay afloat," he said.

He added: "I think everyone should have access to care; I think everyone should have insurance." But, he said, "the insurance market is going to be all topsy-turvy."

Kumar predicts the final healthcare-reform document will have little resemblance to what is in place now as the battle continues to replace the SGR, repeal the IPAB, institute tort reform and find new ways to increase coverage.

Follow Andis Robeznieks on Twitter: @MHARobeznieks.

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