J Gastrointest Surg. 2015 Nov 20. [Epub ahead of print]

Expected and Unexpected Consequences of the Affordable Care Act: The Impact on Patients and Surgeons-Pro and Con Arguments.

Rudnicki M1, Armstrong JH2, Clark C3, Marcus SG4, Sacks L5, Moser AJ6, Reid-Lombardo K7,8; Public Policy and Advocacy Committee of the SSAT.

Author information

• 1Department of Surgery, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
• 2Department of Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
• 3Department of Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA.
• 4Department of Surgery, St. Vincent's Medical Center, Bridgeport, CT, USA.
• 5Advocate Health Care, Downers Grove, IL, USA.
• 6Institute for Hepatobiliary and Pancreatic Surgery Beth Israel Deaconess Medical Center and Dana Farber Harvard Cancer Center, Harvard Medical School, Boston, MA, USA.
• 7Department of Surgery, Mayo Clinic, Rochester, MN, USA. kmariemd@gmail.com.
• 8Division of Subspecialty General Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55902, USA. kmariemd@gmail.com.

Abstract

The Patient Protection and Affordable Care Act (PPACA), called the Affordable Care Act (ACA) or "ObamaCare" for short, was enacted in 2010. The Public Policy and Advocacy Committee of the Society for Surgery of the Alimentary Tract (SSAT) hosted a debate with an expert panel to discuss the ACA and its impact on surgical care after the first year of patient enrollment. The purpose of this debate was to focus on the impact of ACA on the public and surgeons. At the core of the ACA are insurance industry reforms and expanded coverage, with a goal of improved clinical outcomes and reduced costs of care. We have observed supportive and opposing views on ACA. Nonetheless, we will witness major shifts in health care delivery as well as restructuring of our relationship with payers, institutions, and patients. With the rapidly changing health care landscape, surgeons will become key members of health systems and will likely need to lead transition from solo-practice to integrated care systems. The full effects of the ACA remain unrealized, but its implementation has begun to change the map of the American health care system and will surely impact the practice of surgery. Herein, we provide a synopsis of the "pro" and "con" arguments for the expected and unexpected consequences of the ACA on society and surgeons.