The Fate of President Obama's Healthcare Reform Act Now Rests in the Hands of the Supreme Court

On Friday, the 11th US Court of Appeals in Atlanta, GA concluded that the Affordable Care Act, the healthcare reform act passed by President Obama, was unconstitutional.  By a 2 to 1 margin, the Court ruled that the healthcare plan went to far with its "individual mandate," and that it was unconstitutional to force Americans to buy health insurance or else face a financial penalty.  It is not known exactly when the Supreme Court will preside over the appeal, but it could come after the 2012 presidential election.

John Geyman Diagnoses the Decline in Primary Care as the Main Problem with U.S. Healthcare

According to John Geyman, the biggest problem the U.S. healthcare system now faces is the decline in primary care.  In other countries that manage to keep their per capita healthcare costs down, primary care physicians represent a greater percentage of doctors.  Geyman quotes, "research shows that preventive care, care coordination for the chronically ill, and continuity of care -- all hallmarks of primary care medicine -- can achieve better health outcomes and cost savings."  The article: http://www.huffingtonpost.com/john-geyman/the-decline-of-primary-ca_b_922256.html

To me, it seems like part of this problem is that, for doctors, it is more lucrative to become specialists than to become primary care physicians.  After seven years of medical school, student loans are extremely high, and these loans are obviously easier to pay with a higher income.  So, there needs to be a way to incentivize med. school graduates to enter the realm of primary care.  Should this come in the form of fewer years in school?  Probably not, because effective primary care physicians need to have comprehensive health knowledge.  One possible solution: The government could offer student loans at a lower interest rate or more financial aid for those plainning on entering primary care.  If the research Geyman quotes is correct, more primary care doctors will result in more cost savings, so the money will balance itself out.  Regardless, Geyman's assessment is very interesting, and one the government should think about carefully, especially as it readies to expand health coverage to 30 million more Americans.

How Much Will Accountable Care Organizations Change Healthcare?

As it stands now, most health providers in the healtchare industry make money when people get sick.  This is a fundamental flaw in the system, for it does not financially incentivize these providers, such as doctors and hospitals, to ensure that people remain healthy.  A big emphasis of the new healthcare reform is incentivizing individuals to keep themselves healthy and to penalize providers for providing poor care.  The following article does a great job outlining how Accountable Care Organizations, or ACOs, may go a long way in accomplishing this, and how they may change the future of healthcare: http://www.miamiherald.com/2011/08/03/2344316/will-acos-create-a-revolution.html