John A. Goldman, MD
Potential Conflicts of Interest: The author is the chairman of the Medical Association of Georgia Third Party Payer Committee, and he has discussed the Patient Protection and Affordable Care Act at various meetings and online forums. He is also on speakers' bureaus for Pfizer, Amgen, and UCB and receives research support (through the Atlanta Center for Clinical Research) for studies from Genentech, Centocor, Cephalon, Lilly, Merck & Co., AstraZeneca, Takeda, and UCB.
Goldman JA. Comments on the Affordable Care Act and the Future of Clinical Medicine. Ann Intern Med. 2011;154:140-141. doi: 10.7326/0003-4819-154-2-201101180-00027
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Published: Ann Intern Med. 2011;154(2):140-141.
TO THE EDITOR:
Having read Kocher and colleagues' article (1) and rapid responses on www.annals.org, I have many concerns. The article comes from the “no-data zone” and gives us the perspective of persons who have perpetuated the Patient Protection and Affordable Care Act and have probably written a lot of it, which is also not in the authors' disclosures.
Difference of opinion is well respected in our republic, but as a solo rheumatologist perpetually striving to get my patients the care they deserve, I feel the article does not address the many roadblocks to care—insurance companies, lack of tort reform, the use of the sustainable growth rate as a reason not to pay for services, and Local Carrier Determinations by local Medicare carriers used to obstruct care, and with no way for those of us who care for patients to influence their bureaucratic decisions of “no.”
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