In the “fractionated” community of physicians, Joseph J. Tartaglia wants to be a uniter. While often isolated within their increasingly specialized fields, doctors have much in common to bridge their divisions, he said.
Tartaglia, a cardiologist with a solo practice in White Plains and a small-business owner”™s experience, will have a year of opportunity to unite his medical peers in common cause as the newly elected president of the 800-member Westchester County Medical Society. On July 1, he succeeded John J. Stangel, a reproductive endocrinologist in Rye, as head of the 213-year-old county organization, one of the oldest medical societies in the country.
The Bronx-born son of a physician who once presided over the Bronx County Medical Society, Tartaglia takes office at the start of the largely uncertain transition of health care under the federal Patient Protection and Affordable Care Act. “It”™s a little hard to know what”™s going to happen,” he said.
“I was for health care reform, but I”™m really not pleased with this bill.”
Tartaglia said he does not believe the increased costs to expand the Medicare and Medicaid programs to cover more uninsured citizens will be paid for with savings to come from eliminating waste and fraud in those health care programs. “I don”™t think we”™re going to find this money,” he said. “That”™s my biggest problem with the bill.”
“I think New York state is not going to be favorably impacted by it. A lot of the things in the bill, we already have it in New York state.”
If physician reimbursement fees in the state”™s Child Health Plus program are replaced by lower Medicaid reimbursements as part of reform, more doctors might drop out of the Medicare program, he said. “The future for Medicare, if it”™s shrinking payments, I think that”™s going to be an access-to-care problem for the patients.”
Tartaglia said employers of more than 50 workers are weighing their options with a new mandate that will require them to provide employee health insurance plans or pay penalties.
“They”™re doing the math and a lot of the companies may just end up dumping their employees onto the public plan ”¦ I really worry that the climate is going to be where we see increasing lines waiting for care” at public health clinics, hospitals and emergency rooms.
Tartaglia said Congress also failed to address tort reform, which he said is needed to control malpractice insurance costs for doctors and the overall cost of health care.
The bill, he said, also did not restore competition to the insurance marketplace and lift restrictions that prevent doctors from negotiating their fees with carriers. Bills pending in the state Senate and Assembly would allow some collective negotiation, he said. “This is America. Doctors should have a right to negotiate a fee with insurance carriers.”
A group practice with one tax ID “can negotiate a much higher fee than a sole practitioner or a small group,” he said. “Make no mistake about it ”“ small practices are going under. They don”™t just disappear; they join group practices to survive.”
Doctors “have become second-class citizens, basically. We don”™t have any power and we”™re being pawned by different lobbies.”
Umbrella organizations such as the county medical society can give doctors “more clout,” he said. “We need a doctor organization not only to defend doctors, but for the patients. You need to protect the doctor-patient relationship and we need the medical society for that too. You need to preserve some of the autonomy of the doctor to provide that doctor-patient relationship.”
As medical specialties have multiplied, so too have medical groups limited to specialists in a particular field, Tartaglia said. “You have these niches developed for all these doctors and they”™re increasingly isolated from each other. We”™re kind of fractionated.”
As medical society president, “I want to focus on being all-inclusive and reaching all the members,” he said. “I think physicians will recognize more and more the importance of organized medicine.”
“I”™d like to see the government tap into us and see us as a resource. They don”™t need a think tank. We”™ve got it.”
