The YouTube video of the entire show on Iowa Public Television October 4, 2013 Iowa Press episode on the Affordable Care Act and the Iowa Health Insurance Marketplace unfortunately was private so I substituted a shorter version available on YouTube. However, you can view it and see the transcript at this link.
I was not surprised to hear Dr. McGuire say that Iowa will most likely not have enough psychiatrists to meet the demand for mental health care professionals now that Iowans are starting to enroll. I was also not surprised to hear Iowa Insurance Commissioner Nick Gerhart mention that no one has been able to enroll through the federal government web site. Like President Obama, the panel attributed the problem to the popularity of the ACA and the prospect for access to health insurance to those who need it most–lower income consumers, although people in other income levels can benefit.
I was a bit surprised to hear Dr. McGuire say that she was not very concerned about the possibility that there might not be enough primary care physicians to meet the growing need for care. As blogger Psych Practice has said, coverage does not equal care. Psych Practice: Coverage vs. Care. I am concerned about a physician shortage with the influx of newly insured patients for several reasons, the Maintenance of Licensure (MOL) threat being one of them. I’m not sure that being aware of that and making others aware of it is just a scare tactic.
In my opinion, one barrier to making the ACA work in Iowa is the Maintenance of Licensure (MOL) project which the Iowa Board of Medicine (IBM) is actively pursuing. I’ve pointed out several times that very few states are in favor of this kissing cousin of the Maintenance of Certification (MOC). The IBM has bumped me from the schedule and rescheduled me three times to discuss by telephone conference call my opposition to MOL in Iowa at their meetings.
I’ve always made it clear that I’m supportive of lifelong learning and reflective self-improvement. I just don’t believe that MOC and MOL help physicians do that. In fact, it interferes with patient care and there’s no good evidence that they improve patient outcomes or strengthen the patient-physician relationship. See below the LIke button for page navigation.
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