One year after the Patient Protection and Affordable Care Act was signed into
law, implementation is far from complete, there are challenges to its legality
making their way through the judicial system, and the U.S. population is divided
in their strong, varied opinions.
Affordability is the primary concern amongst critics. A recent poll conducted by
the Kaiser Family Foundation found that one in five Americans said they had been
negatively affected by the law, and about half of those cited costs. While
experts say that the impact of the implementations so far has been marginal,
many Americans blamed the law for this year's premium hikes.
"If they have a bad experience in the marketplace, it's very possible they're
going to attribute that to the law," said Mollyann Brodie, Kaiser polling
director. "It certainly presents a challenge for the proponents."
While Sen. Max Baucus (D) of Montana, a lead author of the healthcare bill,
remains a strong supporter of the act, he said that he regrets not giving more
attention to cost control up front. As Baucus said, "It gave detractors an
opening.?
One of the key demographic groups whose opinions analysts have been watching is
the elderly. Senior citizens are especially sensitive to medical costs and have
high voter turnout rates. The senior votes are likely to be critical in the 2012
presidential election.
Although there were worries that Medicare cuts would result in poorer health
care, these fears have not been borne out thus far. Furthermore, the full
effects of change cannot yet be felt because the law will be implemented
gradually, but new Medicare benefits have already started being provided.
One of the major improvements to Medicare so far was a 50 percent price cut on
brand-name prescriptions for Medicare recipients who fall into the troublesome
?doughnut hole? coverage gap.
A Staten Island resident and retired truck driver, Daniel Wisniewski, 69,
reported that this will reduce the price of one of his heart medications from
$234.99 a month to about $117 a month. "I'm not much on politics, but I feel
that that's got to help me," said Wisniewski. "I worked and paid into Social
Security for 55 years. When I was a kid I used to wash dishes in a bakery after
school."
The case of Marilyn Leisz has been decided, with a New Jersey
jury awarding her $115,000 in her lawsuit against a cosmetic surgeon who botched
her blepharoplasty five years ago, leaving her unable to fully shut her eyes.
She contended that her surgeon's negligence in performing cosmetic surgery has
left her unable to close her eyes or blink.
The procedure, a blepharoplasty, is designed to remove excess skin and tighten
eyelids, to give a younger appearance. Leisz?s surgeon took on the operation to
clean up scar tissue from an earlier operation, but he removed too much skin,
and her eyes could no longer close.
Leisz expected to be awarded more in the suit. "I don't think the jury really
took into consideration what I've gone through, what I'm going through, or what
the future is going to be like for me," Leisz said. "When you go in there, you
tend to go in expecting to look better -- not coming out looking like a freak,?
she said.
Leisz?s eyes need constant care, and she has to sleep with a mask to protect
them. she can no longer do things like play tennis or racquetball, watch TV or
work at a computer for long periods, drive in congested areas or even sleep with
her eyes fully closed.
Leisz said, "When I put that mask on every night, it's like putting yourself in
a little coffin."
Her board-certified doctor, Paul Parker, a cosmetic surgeon in Paramus, N.J.,
issued a statement, saying, in part, his center "considers pre-surgical
counseling as important as the surgery itself and conducts extensive interviews
with all prospective patients."
Dr. Parker has said he and his staff fully informed Leisz of all the possible
risks of a blepharoplasty, and insisted that among the things Leisz was warned
of was possible incomplete eyelid closure and dryness. He also maintains he did
not deviate from accepted standards of care in performing the procedure. Leisz
retorted, "There was nothing mentioned on that piece of paper that my eyes would
not close for the rest of my life."
Leisz testified that the only risk Parker warned her of was bruising, swelling
and discomfort. In his summation to jurors seated before state Superior Court
Judge Ralph L. DeLuccia Jr. on Tuesday, Hugh Francis of Morristown, Parker's
lawyer, said it seemed unlikely a woman so experienced in undergoing plastic
surgery on her eyes would have accepted such an answer or not have known of the
other risks. "She had had two ptosis surgeries," Francis said, referencing her
previous blepharoplasties in 2004 and 2005. "None of those other doctors ever
mentioned that?"
Leisz's attorney, Roy Konray of Rahway, said in his summation to the jury that
the doctor should have known better than to do the surgery at all based on
pictures and a physical examination of eyelids that were already tightened to
the limit. "No ? no ? no. That's what Dr. Parker should have said on the topic
of more eye surgery," Konray said.
Generally the risks of blepharoplasties are very low, but they can be
complicated. Beverly Hills surgeon Jason Diamond explained, "Not being able to
close your eyes can result in minor problems, such as tearing, irritation,
blurred vision, and if that's a chronic thing that goes on for too long a time
-- it can even result in blindness."
There were more than 200,000 blepharoplasties performed last year in the U.S.,
according to The American Society of Plastic Surgeons (ASPS).
There is a corrective procedure that Leisz could undergo, in which a skin graft
is taken from behind the ear and placed over her eyelid to stretch it out, but
this procedure also carries risks, and Leisz is wary of further plastic surgery.
If you are considering cosmetic surgery or even minimally invasive cosmetic
enhancements, you should find a board certified surgeon, and look into their
level of experience, consulting personal recommendations from patients.
Critics look past these successes, and predict that such gains will be
temporary. Sen. Orrin Hatch (R) of Utah warned that for families, "any marginal
benefits from this law are far outweighed by the heavy-handed intervention in
their health care by Washington bureaucrats.?
One insurance company?s campaign to get small businesses signed up for coverage
by taking advantage of new tax breaks offered by the healthcare act has produced
mixed results. Many have taken advantage of newly acquirable health coverage,
but some businesses simply aren?t aided by the tax breaks.
One of the chief promoters of the idea is Ron Rowe, an executive of Blue Cross
and Blue Shield of Kansas City. His company?s efforts were praised by Obama
administration officials for the approximately 150 previously uninsured
businesses offering new coverage. Still, Rowe acknowledged flaws in the system.
A typical employee with 10 workers would have to pay about $31,000 a year for
health insurance and recover only 10 percent to 15 percent of that through the
new tax credit.
"The longer this has been out in the marketplace, the less appealing it's been
to small-business owners," Rowe said. Rowe says his company is getting more
interest from business owners by offering a cap on rate increases.