Dear Editor –

Recently, Michael McCreary spoke to the Rotary Club re health care changes; this was written up in a local publication, and I was struck by some inaccuracies and confusion. I know it can be hard to say/transcribe items accurately during a busy meeting, so I wanted to clarify/correct some points.  I hope I have enough space to cover most of them.

First off, contrary to what was stated in the meeting writeup, the ACA does not limit PET scans to three per lifetime; while Medicare was looking at possibly limiting PET scans a year or so ago, they in the end did not do it. As everyone knows, these are two separate programs – Medicare is for people 65 and older (or who are on social security disability); the ACA is a private insurance exchange for the rest of us who cannot obtain affordable insurance elsewhere.

It seem this conflating of the ACA with Medicare happened a few times in the article. The number of people going into Medicare has nothing to do with the ACA; that’s strictly a function of our aging population. One nice impact of the ACA on Medicare though - the general slowing of the growth of medical costs associated with the ACA has been estimated to have extended the lifetime of Medicare by 8 years in just one year of implementation.

Re the Medicaid expansion – I do agree doctors need to be paid sufficiently for Medicaid (MediCal in California) patients. That’s a state issue, and I hope Mr. McCreary, in his position on the hospital board of directors, is working with others in the state to raise the reimbursements. But the Medicaid expansion and getting uninsured people in general health insurance means many more people can now afford to get treatment – both preventive and curative – and that is a good thing. It should reduce the burden on our “Emergency Department” by the uninsured.  (And, of course, as this site recently reported, the ACA looks to reduce hospitals' uncompensated health care costs by up to 5.7 billion, so it is working -  Sierra Sun Times article link)

Mr. McCreary seems unhappy with managed care (the Kaiser model), however, all insurance plans are moving to that model and as it will impact the hospital and clinic, I would expect him as a director to get behind the effort and help make it successful.

Finally, he has a concern with Electronic Medical Records (EMR) systems. We all understand the concern for data being stored electronically; but our banking records, our credit card records, our insurance records, and many more records are stored online these days; EMR systems will help lower costs. Also, the use of electronic medical records are recognized as one important way of improving patient care and eliminating errors.  As Mr.  McCreary is a director, I assume he is working with the hospital to verify that it (and its vendor) are following the appropriate security procedures to avoid hacking.

He mentions a concern with increasing health care costs “burdening” the country by 2020; however the ACA is lowering costs, and will continue to do that.  Healthcare costs are increasing at the slowest rate experienced in many years now because of the ACA. Doesn’t mean we don’t need to continue working at the bill, doing more of what works, and less of what doesn’t. But the ACA means a lot more people are able to get health care; it’s reducing costs; and it’s even helping make Medicare more stable.

If we want to discuss problems with various aspects of the healthcare system – and it is far from perfect – it is important to understand which programs - State and Federal - are involved and not lump all problems as resulting from the Affordable Care Act.  I’m sure most of this was discussed during the meeting, but since it didn’t make it into the article, I thought it was important to clarify.


Anne Brock
Mariposa, CA