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UB Experts Available to Discuss Supreme Court Ruling on Obama Health Care Plan

University at Buffalo law and health care experts are available to discuss the Supreme Court's long-awaited ruling on President Barack Obama's signature health care law.
 
Ruling Could Foster Long Overdue Changes in Health Care System, Family Medicine Professor Says
 
Tom Rosenthal, MD
Chair and Professor of Family Medicine
University at Buffalo School of Medicine and Biomedical Sciences
716-816-7269
 
The Supreme Court’s decision to uphold much of the Affordable Care Act will not only provide as many as 30 million or more uninsured Americans with health care coverage, it may also help foster some important and long overdue changes in the health care system, Rosenthal says.
 
“From a primary care perspective, the most common thing we see in an office setting is that we are now seeing more young people in their 20s than we did because they are covered by their parents’ insurance to age 26,” he says. That change is adding to health care costs because this is a new population that is now seeking medical care.
 
However, in the long run, this coverage will prove to be more economical, he says.
 
“Studies have shown that health care for people without insurance prior to turning 65 and going on Medicare costs close to twice as much in the first few years compared to the costs for those who had been covered by insurance,” explains Rosenthal. “Having continuous coverage is an important part of preventive health care. Addressing health risk factors such as early hypertension, high cholesterol and obesity will save health costs later in life.”
 
He also sees as critical the provision in the law that establishes in 2015 the Independent Payment Advisory Board, a national oversight committee that will evaluate the evidence for specific treatments and procedures.
 
“This committee, modeled after England’s National Institute for Health and Clinical Excellence, will look at the clinical evidence and patterns of outcome for, say, treating hypertension or performing back surgery, and will make recommendations based on that evidence and adjust policy and payments accordingly,” says Rosenthal.
 
He adds that it will not only help patients receive the most appropriate care, but physicians will now have a national standard of care to consider when deciding what course of treatment to follow.
 
“The United States has never had a national standard for care,” says Rosenthal, who adds that other industrialized countries have similar organizations that perform this function. “I think this is essential.”
 
In the end, he says, there will need to be more improvements in the health care reimbursement system to accomplish one of health care reform’s most basic goals: improving access to the best care at the right place and the right time.
 
“Certainly, other health care providers can deliver certain aspects of health care but there are points when patients have the right to have access to a physician,” he says.
 
Therefore, increased demand for primary care physicians would be one outcome, says Rosenthal, who notes that currently, many medical students choose specialties over primary care.
 
“We saw a greater demand for primary care physicians in Massachusetts after they passed their healthcare legislation,” says Rosenthal. “Two years after the law passed, a number of new family medicine residencies in the state opened up. When you insure everyone, you wake up the next morning and say, ‘We don’t have enough primary care providers.’”
 
 
Ruling Upholds Much of Act's Intentions -- With One Exception, Law Professor Says
 
Anthony H. Szczygiel
Professor of Law
University at Buffalo Law School
716-645-3027
 
The Supreme Court ruling on Obama’s signature health care law upholds much of the act’s intentions to expand coverage, with one major exception, says Szczygiel, a health care expert and founder and director of the William and Mary Foster Elder Law Clinic at UB’s Law School.
 
“That exception has to do with the expansion of the Medicaid program,” Szczygiel says. “The president’s health care act encouraged states to expand Medicaid, but the president’s plan also went further and gave the secretary of Health and Human Services the authority to withhold all Medicaid funding -- not just that related to the expansion -- if states fail to expand the Medicaid programs.”
 
Szczygiel says the bottom line is that the Supreme Court ruling will accomplish much of what the act intended, in terms of expanding health insurance.
 
“But the expansion of Medicaid coverage will be a matter of state choice,” he says. “And thus in some states, the added coverage will be more limited.
 
“Everything stays in effect, but the intention of the act to expand coverage is somewhat tempered by the ruling of the court because of Medicaid expansion.”
 
Szczygiel says the Affordable Care Act fundamentally changes the Medicaid program, making it much more like private insurance.
 
“The Court held that each state needed to be able to say ‘yes’ or ‘no’ to that fundamental change,” he says, “without the coercion posed by the threat of losing all federal funding for their current Medicaid programs.”
 
Szczygiel also says the majority decision was “very respectful of the government’s separation of powers.” Congress sets the policy, whether that be good or bad.
 
“If the people don't like it, they can vote against the policy makers,” he says. “The Court only decides whether Congress acted within the authority of the Constitution, and the Court should give Congress the benefit of the doubt when considering that question.”

 

Related Topics:

health care, Obama, supreme court

Campaign 2012: In Presidential Race, Climate Looks Favorable for Republicans, UB Expert Says

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EXPERT CONTACT :

Dr. James E. Campbell

UB Distinguished Professor and chair of the UB Department of Political Science

University at Buffalo College of Arts and Sciences

716-645-8452

jcampbel@buffalo.edu

Campbell is a specialist in American electoral politics and forecasting. He says that with the 2012 presidential campaign in full swing, President Obama's low approval rating and the struggling economy will be key indicators in the election outcome. Campbell also points out that only one incumbent president -- Harry Truman -- has succeeded in retaking the office with an approval rating of below 45 percent.

Additional insight from Campbell:

On President Obama's low approval rating and performance with regards to the economy:

“President Obama has a high 30 to low 40 percent approval rating and historically only one incumbent presidential candidate -- Harry Truman -- has succeeded in retaking the office with an approval rating of below 45 percent. He has plenty of time to bounce back and hit that key threshold, but it is still likely to be a close election.”

“The economy is simply the overriding issue in the campaign. Americans historically have not accepted presidential excuses for a weak economy, so even if the economy shows signs of recovery at election time, the president carries the weight of poor economic performance.”

“Americans want to see performance so for the president to say the recession began on Bush’s watch or that the fault lies with Wall Street will not help with swing or Republican voters. Even the issue of raising taxes on the wealthiest 1 percent may resonate with people, but my guess is that will be seen as a distraction from the general economic weakness and that it actually won’t help him that much.”

On the climate and challenges for Republicans:

“With an incumbent in the race, the presidential record over the last four years will really shape the election’s focus. The political climate looks favorable for the Republicans, but they have to be concerned about having a reasonable candidate that will allow voters to register their dissatisfaction with the incumbent’s record, particularly in respect to the economy.”

“The real driver in how effective the Republicans will be in the race will be in how well they prevent President Obama from going on the offensive. The campaign has to stay focused on the past record because if it becomes about the future, the president has a greater chance of success.”

“The longer the Republican field stays crowded the more it works to Mitt Romney’s advantage, but there is still a great deal of anyone but Romney sentiment out there. He is still the front runner but has not put much distance between himself and the other candidates. The Republican race for a candidate could stay alive right until the time of the convention, but more likely will clarify based on how well Romney does in the southern states."

On the Republican field and who has a chance at winning it:

“Republicans are looking for someone that doesn’t get in the way of voters registering their feelings of contempt."

“The way I look at the Republican candidate field right now is that Mitt Romney is a slight front runner, but he really faces a serious challenge from Rick Perry. He may also face a challenge, albeit perhaps less so, from some of the others including Herman Cain. Cain is a surprising candidate and an untested candidate. In spite of the fact that he has not held public office, he is getting support from a lot of groups that are in the camp of anyone but Romney. His lack of governing experience might help initially with tea party supporters, but when you have an untested candidate with some clear gaps in his knowledge of politics and government that can be a substantial liability against a sharp candidate like President Obama.”

“But look at how this race has moved. Perry has been at the front, then fallen behind. Michele Bachmann has looked strong then fallen back. Through all of it, Romney’s numbers have stayed at about 25 percent.”

“It still seems, however, that about two-thirds of Republicans are still searching for an acceptable candidate. The basis for that might be that religion could be a concern; some may not be comfortable having a Mormon in the White House. And then of course, his record as governor of taking fairly liberal positions and then changing his position on not just one, or two, but on many issues means that he comes to the race with some substantial baggage.”

Related Topics:

Obama, presidential election, republicans

Death of bin Laden is a "major accomplishment for Obama presidency"

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EXPERT CONTACT :
James Campbell, PhD
Professor and Chair of Political Science
University at Buffalo
716-645-8452

 The killing of Osama bin Laden is “a major accomplishment for the Obama presidency” says James Campbell, professor and chair of the UB Department of Political Science and nationally recognized expert in American electoral politics. “I expect his approval ratings to improve somewhat over the next week or so, as a result of this good news,” he says. Campbell says that a five or six percent bounce within the week or so would make sense. “I think it probably also undercuts perhaps some of the advantage Republicans have traditionally enjoyed on national security issues, at least in the short run.”

“My guess is that this could help him a bit with swing voters,” Campbell adds. However, he says, this event probably doesn’t substantially change the issues that will ultimately determine the outcome of the 2012 election. “I don’t think this appreciably changes the fundamentals as they look to be shaping up for the 2012 reelection campaign. I think the principal issues in the campaign will still concern the economy and at this point the recovery has been very sluggish. There’s a good deal of time left for things to turn around, although energy prices are the looming problem and they may cause the sluggish economy to continue in that low growth rate.”
Related Topics:

bin Laden, Obama

Controversy over Ground Zero mosque presents a 'learning opportunity'

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EXPERT CONTACT :

Stephanie L. Phillips

Professor of Law

University at Buffalo Law School

716-645-2201

slp@buffalo.edu

 

The uproar over the construction of an Islamic community center and mosque two blocks from "Ground Zero" has been unfortunate, says UB Law School Professor Stephanie L. Phillips, an expert in law and religion. Nevertheless, she says, it still presents a learning opportunity. 

Phillips says the rancorous debate raises three issues: Do Muslims have a right to erect a community center at that location? Which government bodies have authority to make the decision to grant or withhold permission? And was this a "wise" choice for the building's location? 

 "Concerning the first" Phillips says, "as President Obama has said, the Constitution protects Muslim beliefs and would prohibit discrimination against the planned construction on the ground of the Islamic affiliation of the community center and mosque. 

"Second, the administrative bodies in New York City in charge of zoning and construction standards decided, in the normal course of their work, to issue a building permit; in that sense, this is a 'local issue.' 

"Finally, on the 'wisdom' of the decision to locate the center two blocks from Ground Zero, any criticism of this choice as 'insensitive' widely misses the mark.  The Muslims who are building the center do not associate themselves with the criminals who perpetrated the attacks on the World Trade Center, and, when they chose a location for their new center, there was no reason for them to assume that others would make that association or for them to defer to that mistaken association, if made. 

"If, however, there are threats of violence against the new center, then that may pose difficult safety concerns that must be addressed by the center's administrators and the city. This is a question of protecting the center from the danger of criminal vandalism and violence, not a question of whether it was somehow inappropriate to choose this particular construction site.

 After reviewing the online commentary, Phillips says she most appreciates the posting by a woman who lost a relative on 9/11, at the World Trade Center "who said that it's a good thing there will be an Islamic community center so close to Ground Zero, because its proximity may help people to learn that adherents to mainstream Islam in the U.S. are regular, honorable people, part of the American fabric."

 

Related Topics:

diversity, Ground Zero, Mosque, Obama

American schools need more than a longer school year

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EXPERT CONTACT :

Suzanne Miller

Chair, Department of Learning and Instruction

UB Graduate School of Education

716-645-4071

smiller@buffalo.edu

It will take more than a longer school year to address the problems of the American education crisis, says UB's Suzanne Miller, a national expert in learning and instruction and a former secondary school English teacher. Miller says just spending more time in class and cutting down summer vacation -- a recent proposal made by President Obama -- won't help bridge the achievement gap between American students and others used to more rigorous curriculums.

Related Topics:

education, Obama

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