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The Affordable Care Act and me
When I learned about the Supreme Court’s decision on Thursday to uphold (most of) the Affordable Care Act (ACA) I was lying in bed with a trash can at arm’s length, feeling horribly sick to my stomach. So I received the news with muted relief and dropped back to sleep.
Later in the day, I pulled myself out of bed and walked to the clinic where I work to ask for some help with my dehydration. My supervising doctor, nurse, and medical assistant escorted me to our corner room and into a rich brown leather recliner. They alcohol-swabbed my right arm, stuck a catheter in me, and then a liter of rejuvenating normal saline began its swift descent into my vein.
Later in the day, I pulled myself out of bed and walked to the clinic where I work to ask for some help with my dehydration. My supervising doctor, nurse, and medical assistant escorted me to our corner room and into a rich brown leather recliner. They alcohol-swabbed my right arm, stuck a catheter in me, and then a liter of rejuvenating normal saline began its swift descent into my vein.
Soon after, my fluid status restored, I had a chance to reflect on the role that the ACA may have played in my recovery:
The innovation dollars. I had experienced a nice example of the accountable care organization model in practice: I received care in the lowest acuity setting that could handle my medical problem, so my insurance company and I were spared the time and cost of a trip to the emergency department. (The ACO model incentivizes networks of doctors and hospitals to coordinate care in a way that saves money and promotes high quality care).
Here, also, was a great example of the patient centered medical home at work - a place where a coordinated team of health professionals converged to deliver me patient-centered (and in this case, even patient-prescribed) care when I needed it most. If only I’d had a preventive care visit to counsel me on drinking more water at the outset.
The individual mandate. As a Massachusetts resident, preservation of the individual mandate didn’t affect me much. But I slept easier knowing that more of my future patients will be covered wherever I practice next…
I’m disappointed that the federal government can no longer compel states to expand Medicaid. But I’m hopeful about the other features of the ACA that now have the potential to unroll in the next two years (2012 elections allowing). May they bring us closer to the goal of equitable, patient-centered, cost-effective care for patients like me.
The innovation dollars. I had experienced a nice example of the accountable care organization model in practice: I received care in the lowest acuity setting that could handle my medical problem, so my insurance company and I were spared the time and cost of a trip to the emergency department. (The ACO model incentivizes networks of doctors and hospitals to coordinate care in a way that saves money and promotes high quality care).
Here, also, was a great example of the patient centered medical home at work - a place where a coordinated team of health professionals converged to deliver me patient-centered (and in this case, even patient-prescribed) care when I needed it most. If only I’d had a preventive care visit to counsel me on drinking more water at the outset.
The individual mandate. As a Massachusetts resident, preservation of the individual mandate didn’t affect me much. But I slept easier knowing that more of my future patients will be covered wherever I practice next…
I’m disappointed that the federal government can no longer compel states to expand Medicaid. But I’m hopeful about the other features of the ACA that now have the potential to unroll in the next two years (2012 elections allowing). May they bring us closer to the goal of equitable, patient-centered, cost-effective care for patients like me.
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About the author
Ishani Ganguli, MD, is a journalist and a second-year resident physician in internal medicine/primary care at Massachusetts General Hospital. She studied biochemistry and Spanish at Harvard College and received her More »Recent blog posts
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