By Dan Bump SA-C, CSFA: With so many pages in the law that most legislators didn't even read
them before voting on it, the Affordable Care Act (ACA, sometimes referred
to as Obamacare) has left many students, prospective students, and graduates
of Surgical Assistant Programs confused and concerned about the future
of the Surgical Assisting profession.
So the goal of this blog post is only to comment on whether or not Obamacare
is good for our profession not on the politics or whether or not it is
good for some people. Thankfully, proponents of Obamacare didn't get
what they really wanted, which was 'Single Payer' or 'Medicare
For All.' That could have done some real damage to the profession.
Medicare doesn't pay for Surgical Assistants when they are employed
by surgeons or when they are self-employed unless the assistants are doctors,
PA's, or NP's. Medicare does indirectly pay for Surgical Assistants
through the global payment made to the hospital for services provided
to the surgical patient.
Single Payer therefore could have potentially marked the end of Surgical
Assisting as we know it. I've got to believe, and this is the cockeyed
optimist in me, that Congress would have come together as they sometimes
do in an emergency. The goal? Make Surgical Assistants approved Medicare
providers so they don't all lose their livelihoods and saving money
on the healthcare budget in the process. The alternative would be to spend
a lot more money so that MD's, NP's, or PA's could provide
the very same service.
In the end, the single payer idea didn't pan out. Instead, we have
healthcare exchanges or health insurance marketplaces.
This is still private insurance! Healthcare exchanges are not insurance carriers but organizations that
facilitate the purchase of regulated private health insurance plans that
are eligible for government subsidies. Therefore, they pay for Surgical
Assisting services the same as they did before.
Actually, to make Obamacare work, you need all the mid-level healthcare
providers you can get. So the government would be well motivated to pass
the legislation needed to keep Surgical Assistants working. It appears
surgeon shortages are inevitable. When they occur, more not less Surgical
Assistants will be needed to take the pressure off the remaining surgeons
and the healthcare system. If surgeon A is performing surgery with his
favorite Surgical Assistant, then surgeon B, instead of assisting, is
free to do his own surgeries or handle the overload.
One of the promises made in Obamacare was that healthcare would be less
expensive and families would save on insurance premiums to the tune of
$2,500 per year. Well that didn't turn out to be true. Quite the opposite!
Unless your premiums are being subsidized by the government (really your
taxpaying friends and neighbors), you've probably seen your premiums
go up substantially.
That puts the Obama administration in a dilemma. Apparently they didn't
anticipate that providing health care to more people would cost more and
drive premiums up. Now what to do? Surgical Assistants raise the quality
and lower the cost of surgical care. Increased utilization may even help
the politicians keep their promises regarding reduced insurance premiums.
Surgical Assistants and our profession are currently thriving. However,
if Obamacare is fully implemented, self-employed assistants may take a
little hit because of declining insurance reimbursements. Maybe not. Worst
case scenario, we'll have to get paid by the surgeon or the hospital
instead. Surgical Assistants will still be paid more, which makes it a
savvy career move any way you look at it. The entrepreneurial spirit is
strong among Surgical Assistants and, if the current business model falters
because the rules have changed, we are driven to create new, out-of-the-box
business models that will forge the way to even greater opportunities.
I think the future looks bright for Surgical Assisting almost no matter
which way the political winds blow. So stick with it and let us know if
there is anything we can do to help. Please be sure to comment so your
questions, thoughts, and professional opinions can contribute to this
Are you interested in becoming a surgical assistant? Contact
ACE Surgical Assisting today to
request more information and to learn more about advancing your career.