The health care reform debate raises many complex issues including those of coverage, accessibility, cost, accountability, and quality of health care. Underlying these policy considerations are issues regarding the status of health care as a constitutional or legal right. This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. The United States Supreme Court’s decision in NFIB v. Sebelius, which upheld most of the Patient Protection and Affordable Care Act (Affordable Care Act/ACA), is also discussed.
The United States Constitution does not set forth an explicit right to health care, and the Supreme Court has never interpreted the Constitution as guaranteeing a right to health care services from the government for those who cannot afford it. The Supreme Court has, however, held that the government has an obligation to provide medical care in certain limited circumstances, such as for prisoners.
Congress has enacted numerous statutes, such as Medicare, Medicaid, and the Children’s Health Insurance Program, that establish and define specific statutory rights of individuals to receive health care services from the government. As a major component of many health care entitlement statutes, Congress has provided funding to pay for the health services provided under law. Most of these statutes have been enacted pursuant to Congress’s authority to “make all Laws which shall be necessary and proper” to carry out its mandate “to … provide for the … general Welfare.” Congress has also used other constitutional powers, such as its power to regulate interstate commerce and its power to levy taxes, to enact legislation relating to health insurance and health care.
In 2010, Congress enacted the Affordable Care Act, a comprehensive health care reform law which includes a requirement, effective in 2014, that most individuals purchase health insurance, and which significantly expands the Medicaid program. A number of lawsuits were filed challenging various provisions of this legislation, and, on June 28, 2012, the Supreme Court upheld the majority of ACA’s provisions. Significantly, the Court upheld the requirement that individuals purchase health insurance as a valid exercise of Congress’ taxing power, but the Court limited Congress’ power to spend for the general welfare by holding that Congress cannot threaten the states with the loss of all federal Medicaid funds if the states decline to expand Medicaid coverage as mandated by ACA.
In addition, several states have passed laws, amended their state constitutions, or entered into interstate compacts to attempt to “nullify” or “opt out” of the federal individual health insurance mandate and other federal health care provisions. Direct conflicts between federal laws and state nullification statutes or state constitutional amendments would raise constitutional issues which are likely to be resolved in favor of federal law under the Supremacy Clause of the United States Constitution.
A number of state constitutions contain provisions relating to health and the provision of health care services. State constitutions may provide constitutional rights that are more expansive than those found under the federal Constitution since federal rights set the minimum standards for the states.
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Since EMR is the latest physical therapy documentation system, theres a temptation to simply go with an EMR based on what the vendor says about it, said Chhoda. Dont believe everything youre told and look at several before making a decision. An EMR will be with the practice for many years and impact every part of the business, http://physicaltherapytechniques.com/physical-therapy-techniques/physical-therapy-techniques-revealed/. A physical therapy documentation system must be able to grow along with the clinic.
Chhoda, being a physical therapist himself, said that an EMR should be chosen based on its usability. An EMR created for a hospital instead of a small specialty clinic will cause nothing but problems for a physical therapy business. The selected EMR should be specifically designed for a physical therapy practice and increase the overall efficiency of the clinic, allowing tasks to be completed faster.
Chhoda added that clinicians should consider its ease of use. A clinics EMR should be easy for staff to use and the learning curve should be kept to a minimum. Although mistakes will be made while staff members learn the new system, therapists should also evaluate how easy it is for those mistakes to occur. An EMR shouldnt facilitate mistakes or make it difficult to achieve accurate documentation.
Usability also includes the satisfaction level of users, though its an element thats more difficult to quantify. Authorized users of an EMR should have the ability to create custom documents to reflect the needs of the clinic. The EMR should encompass the ability to add, correct, remove and update patient information as needed in an easy and straightforward manner. An easy interface between staff and the EMR cant be overstated. The EMRs interface should be simple, natural and consistent throughout.
Utilizing Chhodas new insights will assist therapists in selecting the right documentation software for their practice. Clinics will attain meaningful use standards quicker, with fewer mistakes and less user anxiety. Choosing an EMR based on the needs of the clinic is essential for implementing a system that successfully integrates with the office workflow.
Chhodas office can be reached by phone at 201-535-4475. For more information, visit the website at http://www.emrnews.com.
ABOUT NITIN CHHODA
Nitin Chhoda PT, DPT is a licensed physical therapist, a certified strength and conditioning specialist and an entrepreneur. He is the author of “Physical Therapy Marketing For The New Economy” and Marketing for Physical Therapy Clinics and is a prolific speaker, writer and creator of products and systems to streamline medical billing and coding, electronic medical records, health care practice management and marketing to increase referrals. He has been featured in numerous industry magazines, major radio and broadcast media, and is the founder of Referral Ignition training systems and the annual Private Practice Summit. Chhoda speaks extensively throughout the U.S., Canada and Asia. He is also the creator of the Therapy Newsletter and Clinical Contact, both web-based services to help private practices improve communication with patients, delivery better quality of care and boost patient retention.