In Part 2 of our conversation about how health care reform could affect our kids' coverage, Dr. Heim walks us through a typical visit to the pediatrician, explaining what may change and what may stay the same should Obama's health care plan pass this year.
CafeMom: Assuming health care reform legislation is passed, walk us through a typical visit to my children's doctor—what will be the same? What will be different?
Dr. Heim: The care your child receives from your family physician will not change because it is based on medical expertise, which doesn't change as a result of legislation that affects your insurance status. If health insurance reform is passed, then we might see less paperwork and insurance company delay on preauthorizing the tests or medications that your physician recommends. Your physician might begin installing or improving his or her electronic health records to ensure that your child's health information is immediately accessible to the medical and nursing staff every time you visit. You likely won't have to repeat some of the paperwork, such as your child's medical history each time you visit or when you visit a sub-specialist, because the electronic health record will relay that information for you.
If health care reform legislation enables more physicians to implement the same-day scheduling, open-access, and other measures that are part of medical home system of providing care, you are more likely to be able to see your child's doctor the same day your child develops a fever and sore throat. And you probably won't wait as long for a well-child appointment.
Will my doctor be squeezing in more patients and, therefore, have less time to spend with me and my kids?
Dr. Heim: This is more likely to be the case if health reform fails. And you are likely going to have to pay more for your health insurance if health care reform fails.
Part of the health care reform legislation calls for demonstrations of what is known as the patient-centered medical home. This improves on the current model and provides care to patients so that they have an ongoing relationship with their physician, who provides comprehensive preventive care and, if they do get sick, guides them through the health care system and ensures communication and coordination among everyone on your health care team. Part of the medical home includes services such as same-day appointments, extended office hours, electronic visits, group visits and other ways of providing care that are more convenient. Also important to the medical home is the team approach to care. Oftentimes, a straightforward problem—such as an earache—can be addressed by the physician's nurse practitioner. Such a team approach enables your doctor to spend more time with you and your child during other appointments.
The legislation recognizes the value of primary care—the family doctor or general pediatrician, for example—and may begin to increase the number of students who choose these specialties. That will help ensure we have enough physicians available to spend more time with you and your children.
Will my kids be able to get the flu shot, or will we have to wait longer for it?
Dr. Heim: Health care reform legislation has nothing to do with the wait time for getting immunizations. Whether your kids can get a flu shot depends on the manufacturers' ability to produce and distribute the vaccine in a timely manner.
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