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August 5, 2015

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Getting personal with Obamacare

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If you think all doctors don’t like Obamacare, you should talk to a doctor with cancer.

I did. Dr. James Byrnes is a family practitioner, chief of the medical staff at Bethesda Memorial Hospital in Boynton Beach, Fla., and former president of the Palm Beach County Medical Society.

A year ago, Byrnes, 60, was diagnosed with throat cancer.

Byrnes had health insurance. In fact, he made sure that all his office staff — two receptionists, a licensed practical nurse, a nurse practitioner and a medical assistant — had health insurance. He paid for all their insurance premiums.

“When I started doing it, it was like $250 a month and I thought it was no big deal,” Byrnes said.

But over time, those insurance premiums tripled and he was paying about $5,000 a month to insure him and his staff. Byrnes said he had considered telling his employees that they’d have to pay for their own health insurance, but he couldn’t get himself to do it.

“It would be like giving them a pay cut,” he said.

So in July, he thought it was time he shopped around the insurance market to see whether he could get a plan that was cheaper and better for him and his staff. But now he had throat cancer.

“Without Obamacare, I don’t know if anybody would take me. They could say I’m too expensive,” he said. “But my insurance agent told me that now they couldn’t refuse me.”

The health care law, formally called the Patient Protection and Affordable Care Act, is slated to take full effect in 2014. A provision of that law prohibits insurance companies from denying coverage to applicants with pre-existing medical conditions.

“It bumped up my own rates considerably, but they couldn’t say, ‘No,’” Byrnes said. “And I ended up paying less overall than I did in my prior plan.”

Getting lower premiums for the rest of his office staff more than offset the increase in his own premium.

“We now have better coverage, and I’m spending $500 less a month on insurance,” he said.

Byrnes said he understands why some doctors don’t like Obamacare. Doctors are being compelled to switch their records to an electronic system. For him, he said, that’s an up-front, out-of-pocket cost of about $75,000.

“But we were heading in the direction of e-records anyway,” he said. “It prevents handwriting mistakes, which is a big issue for doctors, and it eliminates language problems. The goal of e-records is to improve quality and reduce errors.”

And one day, it could help coordinate care better with other doctors.

“That would be a major help if we didn’t have to duplicate laboratory work,” he said.

Byrnes doesn’t buy the arguments about the new law bringing a more sinister and intrusive role of government in health care, though.

“Some doctors don’t like a panel that isn’t elected that can determine fee schedules,” he said. “But when you talk about socialized medicine, we already have it. Insurance companies base their reimbursement schedules on Medicare.”

And at Bethesda Memorial, millions of dollars a year in medical care get performed on the uninsured by emergency room doctors who know they will never be paid for what they do, he said.

“We’re well off enough as a country that we should provide basic health care to everybody,” he said. “That’s a noble idea.”

And he trusts the government more than the insurance companies.

“With the government, at least you have a voice,” he said. “You can lobby your congressman and negotiate with your government, but you can’t with a big company. They just say, ‘Goodbye.’”

Frank Cerabino writes for the Palm Beach Post in Florida.

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