The start of the new year on Jan. 1 marks the beginning of a mandate under the Affordable Care Act (ACA) for most Americans to obtain health insurance coverage or pay a penalty.
Companies with at least 50 full-time employees have another year (until Jan. 1, 2015) to provide health insurance benefits to workers that meet minimum ACA standards or face financial penalties. Meanwhile, individuals and small businesses in California with fewer than 50 employees have been able to purchase health insurance for their workers through Covered California's Small Business Health Options Program (SHOP). Individuals and small-businesses can access Scripps physicians on Covered California through all Blue Shield plans and the Health Net bronze plan. Covered California has been running smoothly compared to the federal health care exchange, which faced some major challenges at its launch.
Despite its implementation issues and other problems with the ACA, its goals are laudable. It is intended to ensure health care coverage for the 48 million uninsured and to rein in the nation's skyrocketing health care costs, which total more than $3 trillion a year. I have long believed that major changes to health care are needed.
Health care in this country is already changing and must keep evolving, because it's broken. While it is a crisis, it also presents an opportunity for everyone involved, including patients, to identify areas for improvement.
We have to break out of the old paradigm of doctors ordering tests and treatments for patients as an answer to every real or perceived ill. Instead, patients and doctors must partner together to create individualized care plans that make sense, avoid waste and produce the best outcomes.
In addition to the health insurance mandate, the ACA also places more emphasis on wellness and prevention of illness, with hospitals being reserved for the sickest of the sick. Insurance plans now must cover preventive services such as mammograms and annual physical examinations, but the real responsibility lies with the individual.
While preventive care will be covered, for example, it will be the patient's responsibility to schedule and complete screening exams and wellness check-ups, which can identify potentially serious illnesses such as cancer in their earliest and most treatable stages. Also, individuals will be encouraged to take inventory of unhealthy lifestyle behaviors, such as a diet high in sugar, fat or junk food, or a lack of exercise. Such behaviors have been proven to contribute to heart disease, diabetes and other preventable illnesses.
Businesses can encourage their employees to adopt healthier lifestyles through employee wellness programs that promote and reward positive habits such as exercise, weight loss and stress management.
At Scripps, we have had programs in place since 2006 to encourage our employees to adopt healthier lifestyles, including a smarter diet, regular exercise and a healthy work-life balance. Besides being in alignment with the spirit of health care reform, it's the right thing to do for our employees, and Scripps physicians can help their patients make the same types of changes.
Scripps also is working to enhance its services and facilities in ways that are making them more convenient and accessible to patients. Scripps' 26 outpatient facilities are close to where patients live or work. And Scripps is playing a leading role in the fast-emerging world of digital medicine by testing innovative wireless health and telemedicine technologies that will bring health care to patients' homes and even their smartphones, helping them better manage chronic conditions and enhance their regular doctor visits.
The ACA mandates other changes for health care, in effect as of Jan. 1. These include the expansion of Medi-Cal (or Medicaid outside California) to include those with incomes up to 133 percent of the federal poverty level, and a ban on insurers denying coverage for pre-existing conditions. While the ACA and its initiatives may not be perfect, it is the law of the land and a step toward addressing the nation's health care problems.
We know the world of health care won't change overnight. And real health care reform doesn't happen in Washington. It happens when health care providers focus on patients and work with them to deliver the right care, at the right time in the right place.
"To Your Health" is brought to you by Scripps Health. For more information on enrolling in the exchange or to discuss your options, please contact a trained staff member at 1-800-SCRIPPS or visit www.scripps.org.
Companies with at least 50 full-time employees have another year (until Jan. 1, 2015) to provide health insurance benefits to workers that meet minimum ACA standards or face financial penalties. Meanwhile, individuals and small businesses in California with fewer than 50 employees have been able to purchase health insurance for their workers through Covered California's Small Business Health Options Program (SHOP). Individuals and small-businesses can access Scripps physicians on Covered California through all Blue Shield plans and the Health Net bronze plan. Covered California has been running smoothly compared to the federal health care exchange, which faced some major challenges at its launch.
Despite its implementation issues and other problems with the ACA, its goals are laudable. It is intended to ensure health care coverage for the 48 million uninsured and to rein in the nation's skyrocketing health care costs, which total more than $3 trillion a year. I have long believed that major changes to health care are needed.
Health care in this country is already changing and must keep evolving, because it's broken. While it is a crisis, it also presents an opportunity for everyone involved, including patients, to identify areas for improvement.
We have to break out of the old paradigm of doctors ordering tests and treatments for patients as an answer to every real or perceived ill. Instead, patients and doctors must partner together to create individualized care plans that make sense, avoid waste and produce the best outcomes.
In addition to the health insurance mandate, the ACA also places more emphasis on wellness and prevention of illness, with hospitals being reserved for the sickest of the sick. Insurance plans now must cover preventive services such as mammograms and annual physical examinations, but the real responsibility lies with the individual.
While preventive care will be covered, for example, it will be the patient's responsibility to schedule and complete screening exams and wellness check-ups, which can identify potentially serious illnesses such as cancer in their earliest and most treatable stages. Also, individuals will be encouraged to take inventory of unhealthy lifestyle behaviors, such as a diet high in sugar, fat or junk food, or a lack of exercise. Such behaviors have been proven to contribute to heart disease, diabetes and other preventable illnesses.
Businesses can encourage their employees to adopt healthier lifestyles through employee wellness programs that promote and reward positive habits such as exercise, weight loss and stress management.
At Scripps, we have had programs in place since 2006 to encourage our employees to adopt healthier lifestyles, including a smarter diet, regular exercise and a healthy work-life balance. Besides being in alignment with the spirit of health care reform, it's the right thing to do for our employees, and Scripps physicians can help their patients make the same types of changes.
Scripps also is working to enhance its services and facilities in ways that are making them more convenient and accessible to patients. Scripps' 26 outpatient facilities are close to where patients live or work. And Scripps is playing a leading role in the fast-emerging world of digital medicine by testing innovative wireless health and telemedicine technologies that will bring health care to patients' homes and even their smartphones, helping them better manage chronic conditions and enhance their regular doctor visits.
The ACA mandates other changes for health care, in effect as of Jan. 1. These include the expansion of Medi-Cal (or Medicaid outside California) to include those with incomes up to 133 percent of the federal poverty level, and a ban on insurers denying coverage for pre-existing conditions. While the ACA and its initiatives may not be perfect, it is the law of the land and a step toward addressing the nation's health care problems.
We know the world of health care won't change overnight. And real health care reform doesn't happen in Washington. It happens when health care providers focus on patients and work with them to deliver the right care, at the right time in the right place.
"To Your Health" is brought to you by Scripps Health. For more information on enrolling in the exchange or to discuss your options, please contact a trained staff member at 1-800-SCRIPPS or visit www.scripps.org.