Under Obamacare: Your Home's a Hospital; Your Doctor's a 'Team'

By Susan Jones | October 28, 2013 | 6:01am EDT

President Obama signs the Affordable Care Act on March 23, 2010. (AP Photo/Charles Dharapak, File)

(CNSNews.com) - President Obama's former health policy adviser says the law is changing the nation's health care system for the better, as more people are treated by a health care "team," in their homes instead of in hospitals.

Dr. Ezekiel Emanuel, an oncologist, helped to design the Affordable Care Act, and he defended it Sunday on CNN's "State of the Union with Candy Crowley.

"Look, that issue of how the physician-patient relationship is going to change, there's no doubt it's going to change...I think, actually, much for the better," Emanuel said. "You're going to have more of a team. You're going to have nurse practitioners, you're going to have physicians, you're going to have pharmacists, you're going to have nutritionists advising patients.

"The second thing is, a lot more care is going to be moved into the home, out of the hospital, which is very appropriate because we're going to have a lot more ability to monitor people in the home, fewer infections, fewer falls and a big cost savings."

Emanuel said the law already has reduced hospital infections and hospital readmission rates.

As for Americans who are getting cancellation notices from their insurance companies, Emanuel said that's okay -- those plans "are not worth the paper they're written on.

"We would not allow unsafe cars without seat belts, without airbags, on the roads. Similarly, we should not allow health plans out there that are really not health plans," Emanuel said.

"McDonald's had offered a plan it sold to its people for $50 that entitled them to $2,000 of coverage. That is not a health plan. A health plan that excludes certain kinds of care, like maternity care, is not a health plan. We have to have minimum standards."

Emanuel said minimum standards ensure guaranteed issue and coverage of preexisting conditions, "which is what we want."

"All of us are hurting from high health care costs and uneven quality. And (Obamacare) is going to repair those things. And the Republicans never had a proposal to address high health care costs or uneven quality," he said.

Disagreeing with every point Emanuel made, Rep. John Fleming (R-La.), told Crowley that many primary care physicians like himself are not accepting new patients because of decreasing Medicare reimbursement rates; and the workload for doctors, in terms of paperwork, is going up, he said.

"The primary care doctors are more dispirited today than I've ever seen them in history. It's really terrible what's going on out there," Fleming said. "I have a practice today that still operates. We have three nurse practitioners. I'm telling you that every year that goes by we have to analyze what our payer mix is. Can we take Medicaid? Can we take Medicare? This is happening all across the country..."

Crowley said she has heard from primary care physicians, both Democrats and Republicans, who say, "I think this is the end of a guy hanging out his shingle."

"Absolutely," Fleming agreed.

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