title: Expected and Unexpected Consequences of the Affordable Care Act: The Impact on Patients and Surgeons-Pro and Con Arguments.
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.
authors.affiliation: Department of Surgery, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
authors.forename: Marek
authors.initials: M
authors.lastname: Rudnicki
authors.affiliation: Department of Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Armstrong
authors.affiliation: Department of Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA.
authors.forename: Clancy
authors.initials: C
authors.lastname: Clark
authors.affiliation: Department of Surgery, St. Vincent's Medical Center, Bridgeport, CT, USA.
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Marcus
authors.affiliation: Advocate Health Care, Downers Grove, IL, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Sacks
authors.affiliation: Institute for Hepatobiliary and Pancreatic Surgery Beth Israel Deaconess Medical Center and Dana Farber Harvard Cancer Center, Harvard Medical School, Boston, MA, USA.
authors.forename: A James
authors.initials: AJ
authors.lastname: Moser
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN, USA. kmariemd@gmail.com.|Division of Subspecialty General Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55902, USA. kmariemd@gmail.com.
authors.forename: K Marie
authors.initials: KM
authors.lastname: Reid-Lombardo
mesh_terms: D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D058991:Patient Protection and Affordable Care Act; D013514:Surgical Procedures, Operative; D014481:United States
keywords: ACA; Accountable care organizations; Affordable care act; Health care delivery; Health care quality; Health care reform; Health policy; Obamacare; PPACA; Patient protection and affordable care act; Public policy; Public policy committee; SSAT