Attorney: Federal health care law in legal jeopardy

story by Aric Mitchell
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The federal health care law is in legal “jeopardy,” but with or without the law, big changes are needed in America’s health care system.

That’s the assessment of John Alan Lewis, an attorney with Mitchell-Williams law firm, who addressed a group of Fort Smith area small business owners during a Thursday (Feb. 3) luncheon at Hardscrabble Country Club.

Also, Lewis says a simple statement known as “Herbert Stein’s Law” sums up the state of health care in the 21st Century: “If something cannot go on forever, it will stop.”

“It’s sort of obvious, but it’s true. The current health care system finds, in some of the more optimistic situations, physicians receiving payment of only 63 cents for every dollar they bill out. This has been going on for quite some time, but it can’t last forever,” he said.

Lewis added that with the onset of the Patient Protection and Affordable Care Act (PPACA), there will no longer be a “free lunch” when it comes to health care.

“Physicians today work hard to get where they are,” Lewis told those in attendance at the event sponsored by Arvest Bank. “They put in four years of medical school and an additional 3 to 8 years toward their doctorate while working long hours for what is essentially minimum wage. By the time they can finally practice on their own, they’ve amassed a lot of debt, and then are lucky to collect two-thirds of what they bill out due to unpaid care. They want to enjoy a balance of work and life, but it’s hard to get that call late at night and head in to work only to discover that a) you’re not going to get paid for the work you do, and b) you’re probably going to be sued.”

Lewis cited a striking correlation between medical malpractice suits and unpaid medical care.

While the new federal health care law is designed to get more people insured so that physicians are not eating so many unpaid bills, Lewis said it could result in further rationing of medical care.

“We already ration healthcare to a certain extent through transplant lists,” Lewis said.

He noted that as the number of patients goes up and the amount of available physicians shrinks, there could be a need to increase rationing of health procedures.

The number deficiency Lewis mentioned refers in part to the fact that as of 2012, 450,000 practicing physicians will be more than 50 years of age. With approximately 23,000 leaving each year due to death and retirement and only 16,000-17,000 new physicians graduating from medical schools annually, the shrinking figure will be ill-prepared to handle the growing number of health care patients in programs such as Medicare and Medicaid.

At the Arvest Bank-sponsored event planned around the theme of “Medical Economics,” Lewis said that as of Jan. 1, 2011, baby boomers (those born from 1946-1964) are turning 65 years of age at a rate of 10,000 per day. Approximately 78 million are expected to become eligible for Medicare and Medicaid in the next several years. By 2050, 19% of people in the U.S. will be elderly.

With a shortage of physicians looming, and many choosing to drop their roles as Medicare and Medicaid providers due to lesser compensation, the health care issue is one that will need to be addressed with or without the new federal health care law in the next few years. And with recent legislation in Virginia and Florida striking down the health care bill as unconstitutional, it could very well be without.

Lewis noted from his standpoint as a legal professional with the Mitchell-Williams firm in Northwest Arkansas that the federal health care law has serious legal hurdles to overcome.

“The Virginia and Florida decisions were well-reasoned documents, and they will hold a great deal of weight when the case reaches the Supreme Court,” Lewis said. “I can assure you that (this) health care (law) is in jeopardy.”

Lewis attributes remaining difficulties for the new law not just to the courts, but also to false statistical projections about the ways the law will improve health care. He also cites that “employee dumping” and the costs of “systemic restructuring” may doom the legislation.

When asked how he felt corporate America would react to the health care “exchanges” that go into effect in 2014, Lewis predicted many employers will probably drop health care from a benefits package, but that they may give their employees an increase in compensation that will allow them to afford the government-run plans.

While Lewis’ presentation addressed the pros and the cons of the new health care package, some in attendance were not convinced of its viability.

“I think the worst part about the health care plan is that no one understands what’s in it,” Scott Clark of Clark Family Chiropractors said following the event. “When the leaders are able to opt out of this program that is being mandated on businesses, that’s a real test to its legitimacy. Its vagueness and the fact that no one can pinpoint everything that’s in it makes the public feel like the government is taking more control of their lives with no clear guidelines.”

“The theory behind it is positive,” added Robert Halliburton of Arvest Bank. “It’s easy to love the idea, but the real test lies in its execution.”