The Big Story Blog

First Person: The cardiologist

Posted at 4:40 PM on June 28, 2012 by Paul Tosto
Filed under: Health, Politics

Editor Note: MPR's Molly Bloom reached out to Minnesotans in our Public Insight Network for perspective on the Supreme Court's decision upholding much of the Affordable Care Act.

Peter Eckman
Peter Eckman s a heart failure and transplant cardiologist at the University of Minnesota.


As with any law, it has its flaws and opportunities for improvement, but I think the overall result is a good thing for the health of Americans. I was pleased to see that the core of it was upheld by the Supreme Court. I think it will improve access to care for millions of people.

As a physician, some of the challenges that I think patients face in the United States involve access to care. They delay access or don't seek medical attention due to their concerns about access to care.

I've seen people that haven't gotten recommended testing done because they're afraid of being deemed as having a pre-existing condition and therefore will be ineligible for insurance - or only eligible at rates that are unaffordable.

Another example I've seen as a physician, particularly in a tertiary care center like the University of Minnesota, are patients that have had multiple medical problems. I can give an example of someone who had cancer as a child.

The chemotherapy that was used to treat that eventually led to heart disease and he subsequently needed a heart pump and eventually a heart transplant.

It's not unusual for people to need multiple episodes of very sophisticated care and in some cases we've run into obstacles from insurance companies who would say, "I'm sorry. You've hit your lifetime maximum. We're not going to pay anymore." It's a very small group of people, but it's a group that has very high medical needs and we won't have to deal with this barrier anymore.

My personal take is that this is no more of an individual mandate than it is to have to buy car insurance or pay taxes to cover the fire department.

Hospital systems are obligated to provide care to people regardless of their ability to pay, but we haven't had a mechanism or system in place that insures that everyone is making as fair a contribution to the system as possible.

About Paul Tosto

Paul Tosto

Paul Tosto writes the Big Story Blog for MPR News. He joined the newsroom in 2008 after more than 20 years reporting on education, politics and the economy for news wires and newspapers across the country.

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