Three spine surgeons discuss healthcare regulatory burdens.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.
Next week's question: What is the most pressing financial challenges facing your practice at the moment?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Feb. 15, at 5 p.m. CST.
Question: Which regulation governing the healthcare industry would you like to see overturned?
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: Four things must be changed or overturned. Firstly, there must absolutely be tort reform mandated on a federal level. Malpractice award caps and other safeguards must be attached to the law if we are to keep costs down and keep physicians from leaving areas or from restricting their practices.
Secondly, insurance companies must not have unrestricted ranges on raising premiums. Just like a rental agreement, they should be limited to no more than 2 to 5 percent per year cap on raising premiums. It is ridiculous to raise premiums 50 percent — did it really become twice as expensive to take care of the same patient pool? Or is it just your shareholders and executives who are the ones asking for it?
Thirdly, the insurance companies must accept the preoperative establishment of medical necessity as a contract for payment for services. The disconnection between the authorization of services and provision of payment is intentionally disjointed and must be fixed.
And finally, the Independent Payment Advisory Board must be banished and an oversight mechanism for the CMS must be established.
Richard Kube, MD. Founder and CEO, Prairie Spine & Pain Institute (Peoria, Ill.): In Illinois it would be the certificate of need. A free market would allow competition and enable costs to drop. Need should be determined by the public, not a panel. If your services are needed, you will thrive. If your services are not needed, you will go bankrupt. It is the only fair solution; no picking of winners and losers by the elected and their appointees and lobbyists.
Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): Repealing and replacing Obamacare would be great.