Given that actual details of healthcare reform are still being worked out, Anthony Poggio, DPM, notes subsequent elections could alter the balance of power in Congress and possible modifications to the program could occur.
Healthcare reform will benefit different types of podiatric physicians in different ways, according to Babak Baravarian, DPM, FACFAS. He says those with a large number of low-income patients will benefit the most while those with a large private pay practice may see decreases in their reimbursement. Dr. Baravarian notes that about 30 cents of each healthcare dollar spent goes to actual medical care and suggests reining in overhead to decrease costs.
“I think overall very little will change,” Dr. Baravarian says of the reform. “I don't believe the insurance being offered is of much use to those with insurance. It will benefit low-income patients with no insurance but I think a limited number of doctors will accept the insurance.”
There also needs to be control over end of life issues and payment, according to Dr. Baravarian, the Director of the University Foot and Ankle Institute in Los Angeles.
Both Drs. Poggio and Baravarian would like to see more discussion on malpractice reform. Dr. Poggio notes that the practice of defensive medicine is real and does add to the overall healthcare cost. He also sees a possible correlation between the national healthcare systems in other countries and the fact that those countries have very low rates of litigation.
Megan Lawton, DPM, agrees with the need for malpractice reform and also calls for tighter regulations on insurance companies. She favors a provision that would include individual responsibility for one's own health, which would potentially lower some healthcare costs.
William Fishco, DPM, advocates amending Title XIX of the Social Security Act to include podiatrists as physicians. He notes that Arizona has a recent law that excludes podiatry services provided by a podiatrist to Medicaid patients.
“I doubt that primary care physicians, physician assistants, nurse practitioners, dermatologists or orthopedists are going to provide our services (for patients with diabetes),” notes Dr. Fishco. “I am sure that these providers do not have the time or desire to do so.”