Dr. Ted Epperly's Book Fractured and the Debate on Reforming Health Care
Justin Skenandore and Andy Hyer
Considering the U.S. Supreme Court's ruling this July on the Affordable Care Act, the next steps in health reform have become a popular topic of conversation across the nation. With the possibility of big changes to come, policymakers in Idaho have been investigating what steps to take next.
One prominent and knowledgeable figure in the debate regarding health care reform in Idaho and nationwide, is Dr. Ted Epperly. Dr. Epperly is a family physician of 32 years who lives in Boise, Idaho. Currently he sees patients, teaches family medicine residents, and directs the Family Medicine Residency of Idaho. He is the past president and chairman of the board of the American Academy of Family Physicians. Much of his time is devoted to sharing his wealth of knowledge on health care reform, including several meetings with President Obama and members the U.S. Senate. He is also currently serving on various health-related governmental commissions and work groups in Idaho. He recently published a book entitled Fractured: America's Broken Health Care System and What We Must Do to Health It.
In July, we sat down with Dr. Epperly to discuss his new book, why he wrote it, and the future of health care and health reform in Idaho. Below are a few highlights from our conversation.
America's Broken Health System: "The Most Advanced Fire Department in the World"
Throughout our conversation, Dr. Epperly referenced the many problems with our current health system in the United States. Specifically, he explain that, "In essence America has created, so to speak, the most advanced fire department in the world but is not asking or looking to see what is causing the fire." In other words, our health system should focus more on keeping individuals healthy.
Focusing more on prevention and keeping people healthy, Dr. Epperly explained, would reduce costs and make our society more productive. "Treating individuals before they experience serious complications is much cheaper." In addition, keeping individuals healthier will allow people to be more productive--meaning less time out of school and work because of illness. Dr. Epperly further explained that the current health system is a system of "have and have not, which hurts America."
Dr. Epperly explained that he wrote Fractured to help provide people with accurate information with what is wrong with our health system. "Many people have dug in their heels due in part to a lack of understanding about heath care and how it truly affects individuals." Dr. Epperly went onto explain that there is a lot of lobbying by different groups to keep the health care industry the "moneymaking machine" it is for them. In light of this, Dr. Epperly decided his focus should be to educate the public so that they fully understand the situation and are able to decide for themselves.
In our interview, Dr. Epperly reiterated his experience at a public forum on health reform in 2009, as a catalyst for his decision to write Fractured. Dr. Epperly explained that the debate became very hostile and one sided. As he put it in Fractured, "I was dumbfounded at the distortions of truth and at the basic misunderstandings underlying much of what was being proposed within both the Senate and House health care reform bills" (p. 4). He shared with us that upon leaving the event, his wife asked him "So Ted, what are you going to do about that?" He replied, I'm going to write a book to better educate the public on health care in the United States.
The Affordable Care Act: An Imperfect, Yet Significant Step in the Right Direction
Dr. Epperly shared his view that although the Affordable Care Act, is imperfect, it is a necessary step in the right direction. In that regard he expressed his support for the Supreme Court's recent ruling upholding the major provisions of the law. Dr. Epperly also expressed his respect for President Obama in taking on health reform. "He knew he was going to take a lot of heat. But he said he would rather be a one term president who takes on health care reform than a two term president who turned his back on the topic."
In our conversation, Dr. Epperly reiterated the view he expressed in Fractured that "[a]lthough this bill is certainly not perfect in every provision, it makes a starting point for continued reform in our health care system that is long overdue" (Fractured, pp. 192-193).
Upcoming Decisions for Idaho Policymakers
Dr. Epperly also shared with us his insights on the decisions policymakers in Idaho must make. The Supreme Court upheld nearly all of the ACA, but said that each state can decide whether to continue with its current Medicaid program or expand their Medicaid programs. Thus, Idaho lawmakers will need to decide: (1) whether to expand Idaho's Medicaid Program and (2) whether to create a state-run health insurance exchange. The Idaho Legislature's Health Care Task Force and two work groups created by Governor Otter are currently investigating these issues.
Dr. Epperly explained that creating an insurance exchange will allow easy access to insurance coverage information and avoid confusion in choosing a cost-effective plan. In his view, state lawmakers have three options for choosing an insurance exchange in Idaho: (1) the Governor reconvenes the legislature to create a state-run exchange; (2) the state takes no action and the federal government creates an exchange in Idaho; or (3) Idaho joins a regional exchange.
Our Take on Fractured
As Dr. Epperly stated in the Introduction to Fractured, "My purpose is to educate and to better explain what is going on with our health care system" (p. 4). Fractured certainly fulfills this stated purpose. It contains a wealth of accurate and up-to-date data on health care, presented with helpful explanations and analogies. Additionally, Fractured offers an insider’s view on the policymaking process, why enacting health reform has proven so difficult in the past, and why the ACA contains the provisions that it does.
Of course, Fractured cannot and does not attempt to answer every possible question regarding how to fix the health system. However, Fractured certainly offers an explanation of health care in United States that is both accurate and accessible and compelling for a broad audience. Idaho is certainly fortunate to have a leader like Dr. Epperly informing the health care policy debate.
For more information on Fractured, please see: http://fracturedhealthcare.com/.
Justin Skenandore, BS, is a student in the Master of Health Science program at Boise State University. He currently works at the Idaho Commission on Aging. email@example.com
Andy Hyer, JD, MHS, is a Lecturer in the Department of Community and Environmental Health at Boise State University and serves as President of the Idaho Public Health Association. firstname.lastname@example.org.
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