Q&A: KevinMD weighs in on healthcare in New Hampshire

Kevin Pho, MD, is the well-known KevinMD in the blogosphere, on Twitter and elsewhere. He also practices medicine in Nashua, N.H.

Leading up to Tuesday’s primary in the Granite State, Pho spoke with Government Health IT Editor Tom Sullivan about the healthcare issues important to his state, how politics influence Americans’ perception of health reform, and whether a Republican president could really repeal the Affordable Care Act (ACA).

Q: What aspects of healthcare are unique to New Hampshire? And which issues are paramount to primary voters?

A: Like Iowa, there are a lot of rural settings in new Hampshire. I happen to practice in Nashua, which is less of a rural setting. But a lot of patients come in, their insurance is changing, their premiums are going up, they have more out-of-pocket responsibility for their care and these problems aren’t unique, necessarily, to New Hampshire, but people are feeling a lot of these problems that other patients in the country are feeling. And they’re sharing a bigger load of their care, combine that with the rising unemployment rates people have concerns about the rising cost of healthcare. So these are issues that we a population need to face and a lot of the solutions that I hear during the Republican debates as it pertains to healthcare need to go beyond where they are now. We need ideas, such as replacing the Affordable Care Act with what? I don’t see anything concrete there.

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Q: How do you think Americans' perception of health reform is distorted by the politicking in these elections?

A: Health reform in general is very polarizing, especially with politicking. It gets framed in a way that’s black or white, right or wrong, and the issues facing our healthcare systems are significantly more nuanced than that. It goes beyond the soundbites that politicians use to portray health reform.

Let’s take an issue like the rising cost of healthcare. The reasons for something like that are pretty complicated. A lot of the solutions involve cutting back on care, thinking twice about the care we give patients and, really, it’s not conducive to a political platform. So I do think that there’s distortion because of the politicking and the campaign promises and I think the public needs to face the harsh reality that we need to make difficult decisions going forward, and that’s not something most politicians want to tackle.

Q: There are certain phrases bandied about that sparked my last question: "socialized medicine," "death panels" and even the term "individual mandate."