A second term under President-elect Donald Trump has a broad range of implications for the direction of healthcare policy and spine care.
Four spine surgeons share the changes they're anticipating in the years ahead.
Question: What does a second Trump presidency mean for spine surgery and practice management?
Harel Deutsch, MD. Rush Spine Center (Chicago): The Affordable Care Act resulted in increased regulation and complexity that resulted in more physicians working in an employed market. The last few years has seen the increased prevalence of medicare advantage plans. I forsee that in a second Trump presidency, Medicare advantage plans will increase and therefore further restrictions or denials for spine surgery.
Brian Fiani, DO. Spine surgeon. (Birmingham, Mich.): A second Trump presidency could have various implications for spine surgery and practice management, particularly in terms of healthcare policy and regulations. If previous policies are reinstated, we might see changes in reimbursement models, which could affect how spine surgeries are funded and managed. Additionally, there may be a push for more deregulation, potentially impacting quality control and reporting requirements in surgical practices.
However, it's also important to consider the potential for increased focus on specific healthcare issues, such as opioid management and pain management strategies following surgery, which could shape practice protocols and patient care standards in the spine surgery field. Overall, the exact impact would depend on legislative priorities and the political climate at the time.
Vladimir Sinkov, MD. Sinkov Spine. (Las Vegas): While it is nice to dream, realistically I do not expect any significant changes. The $4 trillion U.S. healthcare industry is very complex. There is a lot of money to be made and the powers that currently control this system (the government, insurance companies, and the hospital systems) are very unlikely to allow the system to change or improve in any significant way. So the reimbursements are likely to continue to decrease, regulations are likely to continue to become more burdensome, and the physician's independence is likely to continue to decline.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): President-elect Donald Trump's (anticipated) return to the White House will likely bring changes to the nation’s crippling fraud and abuse in public health insurance programs, optimistic increases in funding for Medicare/Medicare coverage and a refocused alignment with the Veterans Administration and its clientele. What remains to be seen is the dealings with the overly moneyed pharmaceutical industry and the unwinding of their strangle hold on the populace in pricing and control. Both appointments in HHS and CMS are patently patient-focal individuals, who have pledged/been tasked with remedy to a system fraught with health challenges and dwindling funding that parallels this country's burgeoning debt and remittances. Health insurance premiums are constantly expanding, and services are scarcer.
Spine surgery and its science of complexities/variabilities will remain a prime convergence in healthcare, because of cost and usage, but also because of its ubiquitous prevalence and place in neurological disease. Robotics is in its advent of efficacy, safety and affirmation and will require more time, research and acceptance to become a household leader.