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September 05, 2013
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The world is always changing and no where is that more true than with healthcare in the United States.  I have seen many changes since I started practicing podiatry in 1990.  Many of these changes have been good ones as new technologies have made medicine more effective and efficient.  Treatments and the ability to diagnose conditions have improved with the use of new advances in machines and computers.  Medicine has become very costly in the United States due to the high cost of the new technologies, medicines and certain doctor fees.  The growing power and influence of insurance companies have resulted in huge profits in some cases and enormous bonuses and salaries for some of their executives.  In effect, some healthcare dollars have been switched from paying doctors and providing care to these salaries. The bottom line is that if the current system were to continue, it would eat up more and more of our national budget leading the system to eventually collapse.  Simple economics and politics are combining to create more change.  Obamacare is an attempt to expand healthcare to more of our citizens and to control costs.  I see both benefits and problems in the plan.  It definitely does expand coverage and there are certain protections, such as not allowing insurance companies to reject coverage due to a pre-existing condition, that are positives.  It does seem to create more choices of insurance coverage for people and competition, which should somewhat control costs.  The problem is that it costs a lot of money to insure so many new people.  There are new taxes to pay for subsidies.  This is a drag on the economy.  Many people are also being added to the medicaid population.  These people will receive subpar healthcare in many situations.  The plan also did very little to address tort reform.   Doctors are often forced to order tests to protect themselves against malpractice claims.  These tests are very expensive.   The burden of very high malpractice premiums also drives up the cost of healthcare.  Doctors are also being weighed down with new regulations and requirements.  I find that while the rewards of helping a patient achieve better health could not be more rewarding, the non-medical aspects of running a practice is draining.  There will certainly continue to be changes.  There is more responsibility than ever on the patient to pay for a larger share of their insurance and healthcare.  We must all speak up and voice any concerns to our politicians.  Many future changes will be determined by this input.  

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