In some ways, Dr. Julie Anderson was four years late to the prom: She attended Tuesday night's State of the Union address but found that her pressing issues weren't discussed and health care took a back seat to immigration and the minimum wage.
But the St. Cloud family doctor relished the invitation from Rep. Michele Bachmann, R-Minn., and the chance to tell the congresswoman her concerns about regulatory changes that have slowed her medical practice.
Anderson's clinic has experienced hiccups and delays due to MNsure, the state exchange created under the federal Affordable Care Act to expand health insurance in Minnesota. One of her nurses was on hold for 150 minutes with the MNsure hot line, trying to verify the insurance status of a homeless patient.
But Anderson's angst is more with ACA regulations that make it harder to order home medical supplies for patients. She used to make one phone call when patients she had known for years called and said, "Grandma's been falling. She needs a walker." Now, she says, such an order requires an in-person evaluation of the grandmother and a series of forms.
"I used to spend 90 percent of my time talking and listening to patients," she said. "Now I spend probably half my time talking to patients. The other half is spent on the computer screen signing forms for apnea machines or scooters."
Anderson e-mailed her concerns to Bachmann's office in early January and was invited later that same day to attend President Obama's fifth State of the Union address.
The additional paperwork for medical supplies was added in an effort to reduce fraud in the federal Medicare program. Billions of dollars have been wasted each year paying Medicare claims that were fraudulent or were "up-coded," meaning they paid for Cadillac-level equipment when patients got only Yugos.
The problem must be addressed, but the current solution comes with a cost that needs to be considered, Anderson said. "It's just affecting the ability for me to really connect with my patients."
