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Anonymous, I thought you were accusing me of being uneducated about the ACA. I didn't realize you were accusing me of being uneducated about chronic pain. Because if I had, I'd have really been offended. I have Crohn's disease and gatroparesis. There's not a single day that goes by -- indeed not an hour -- in which I am not in pain.

Much of what you complain about has NOTHING to do with the health reform law. There were lots of problems with health care before and the law didn't purport to address them all. For example, the health reform law doesn't allow coverage of illegal immigrants, whether or not I think that's a good thing. And nothing in the health reform law stops your GP from continuing to have a small practice -- it's entirely up to him. The economics of health care in America are such that it's harder and harder for solo practitioners, but that trend started way before health reform.

I actually agree with a lot of what you say. I just think you're blaming it on health reform when in fact, what we need is even more regulation of the health care industry. What's crazy to me is that doctors are still making a mint, pharma is making a mint, hospitals are hiring more and more doctors on staff to try to get patients to seek care within the hospital system so they are making a mint. In other countries where health care is more affordable, nobody's getting as rich off the system as people are in the United States. We need incentives for doctors like yours to keep doing what they're doing -- and I know it's harder and harder for them to do so. But that has nothing to do with health reform. Indeed, health reform prizes primary care and patient-centered primary care medical homes.

So I think you and I actually agree about a lot. J

June 27, 2011 - 7:19am


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