Editor,

The Patient Protection and Affordable Care Act that became law earlier this year has become such a politically charged issue that many people have forgotten that it contains some positive provisions that will go into effect this fall.

As a family physician, the second largest percentage of my time (behind patient care) is spent fighting with health insurance companies trying to get my patients the care they need.

Over the years I have been in practice, there have been so many times when the insurance companies denied services that are well-accepted screening practices and have denied coverage for pre-existing conditions.

I remember one family who was declined for family insurance coverage because their then-10-year-old son had a tonsillectomy when he was six and the insurance company called that a pre-existing condition. (He had not been sick since his surgery four years before.)

The health reform law provides long-overdue patient protections against predatory health insurance practices and will require health plans to cover certain preventive services, such as cancer screenings and wellness services. Until now, Medicare did not cover an annual wellness exam, though it covers specific items of health screenings.

A few provisions that will make an immediate positive impact include the ability of young adults to stay on their parent’s health insurance until they turn 26 years old; the end of the practice of rescission, or cancelling coverage for patients after they get sick; and stopping insurance companies from denying patients coverage because of a pre-existing condition.

Current health care policy and reimbursement strategies in the United States emphasize specialty care over primary care. Because of that, few medical students choose primary care fields – family medicine, general internal medicine and general pediatrics – for their career.

Many countries have health outcomes that are much better than ours here in the U.S., and in most of these countries, nearly 50 percent of their physician workforce are primary care physicians.

One criticism of the law is that expanding health coverage to millions more Texans will overload our already strained primary care workforce, especially in rural areas that are already experiencing physician shortages.

I worry that when I retire (which won’t be anytime soon, by the way), there won’t be another family physician to take my place.

The law addresses this concern through incentives that provide scholarships and loan repayments for primary care physicians who agree to practice in medically underserved areas. Payments to rural health care providers will also be increased, providing another incentive for physicians to come to our area.

In short, the health reform law is complex and implementation will be a lengthy process. There are some parts of the law that I believe are not good, but our elected officials have time to improve those provisions.

More importantly, parts of the law are extremely beneficial to my patients and I believe they will improve our health care system.

Let’s not “throw the baby out with the bathwater,” but rather work for the needed changes to ensure that our health care system results in the best health care in the world.

Thomas E. Mueller, M.D.

Columbus