Last night health care reform finally was passed by a vote of 219 to 212 and President Obama will sign it into law. An enormous amount of unnecessary drama was injected into the process, and that will take some time to dissipate. Though while politics dominated the characterization of the bill for the public psyche, the practical aspects of health care reform will gradually begin to dominate over time – and the actual effects of the legislation will become apparent as does a photographic image does in the developing process (before digital, that is).
Much will be written and said about what this means. My own small part is this – over time, there will a very large influx of people entering the health care system who have never had real access to care before. They are people who either used an emergency room as their source of primary care, or who simply went without and did not get preventive services that could keep them from developing conditions such as diabetes or pre-natal care. Now, as the new system kicks in, over the next span of years, these people will come in from the cold.
As always, change poses some challenges but also affords some opportunities for all health care stakeholders.
For example, conventional wisdom states that there are not enough physicians in the country to absorb over 30,000,000 new people into the system. That's a challenge, but it is also an opportunity for anyone interested in working in health care. If there are not enough physicians, it naturally means that the roles of physician assistants, nurse practitioners and nurses in general are all going to grow. As well, the role of pharmacists is going to probably expand as people look to physician-surrogates for support if there is a shortage of physicians. And lastly, it means that in states where there is legislation to wide prescribing capacity beyond physicians, there is new reason to pass it.
It might be a good measure for corporate social responsibility among the medical product manufacturing industry to see how it might want to lend support to the situation, such as the creation or enhancement of scholarship opportunities for people today who would like to gain education for one of these specialty areas today, so that when the formerly uninsured enter the market, there is a stronger system to absorb the impact.
Lastly, as more people enter the system who have never had health care before, health care literacy is going to also take on a more important role for everyone. That is something for FDA to consider now, along with industry. Antibiotic resistance is but one example – where there is still a need for all people to get a better understanding of the role of resistance – a challenge compounded when adding millions of new people.
Now that the political dust hopefully settles – at least a bit – it is time to focus on the real work ahead.