When I first met my husband Paul, I remember him telling me that he chose to become a general surgeon for two main reasons: One, he absolutely loves helping sick people get better. Because he is a compassionate person and he loves people, he absolutely loves being a doctor. With each patient he cares for, he always asks himself this important question: “What if this person was my own wife, mother, or child, etc.; how would I want them to be treated?” Paul sees each patient as an individual who has value. That’s what he’s supposed to do –since he took that Hippocratic oath in medical school (which basically acknowledges the intrinsic value of every human).
The second reason why Paul loves being a doctor is that he loves the independence that comes with being a small business owner. “I just love being my own boss,” he tells me all the time.
Yet, Paul is certainly not the only physician who has chosen the medical profession for the art of healing and the love of independence. Many other of our nation’s brightest have also chosen the medical profession for these two very same reasons. So, it is no wonder many doctors are concerned about the Affordable Care Act— their two main incentives (for practicing medicine) are now at stake with Obamacare.
While the mainstream pundits may be focusing on those “evil” insurance companies, or which Republican or Democrat to blame this week, or what kind of legacy the healthcare law will leave our sitting president, I can’t help but to ask, “What about the two people this healthcare law impacts the most—the doctor and patient?
Like my husband, most physicians just want to take care of their patients and not have to deal with more regulations and more government bureaucracy. As Dr. Tim Shepherd, a family practice physician in Texas explains:
Every person is a unique individual, and you can’t cookie-cutter medical care; it’s individualized. I am concerned about health care under the new law, and my patients are very concerned…
In the past three decades, I have seen health care become more and more regulated by government. Of the 15 employees I hire, five of their jobs are completely devoted to filling out insurance forms and government paperwork. All that administrative work can detract from time spent on patient care…
It makes it difficult to take care of the whole person—body, mind, and spirit—if you don’t have an environment where you are free to do that. The biggest problem with Obamacare is that there are going to be layers and layers of government bureaucracy that will try to tell me how to treat patients I’ve helped for over 25 years. More federal control is the foundation of it.
These new boards and commissions to be established under Obamacare will tell doctors: “These are the procedures you will do, and these are the ones you will not do.” Treatment will be restricted, reimbursement will be further decreased, and more doctors will retire early, as I have already seen with many colleagues.
Dr. Shepherd also addressed another big concern for many physicians — that they can no longer afford to practice medicine under these new Obamacare conditions. Dr. C.L. Gray, founder of Physicians for Reform, and a hospital-based physician in North Carolina writes:
Half of the people who gain insurance through Affordable Care Act (“Obamacare”) do so by enrolling into Medicaid. For many states this means the size of Medicaid under the Affordable Care Act (“Obamacare”) will exacerbate both federal and state budget shortfalls and force states to cut Medicaid reimbursements to physicians even further.
In many states, Medicaid already reimburses less than the cost of delivering care. This means that even though these “newly insured” patients have healthcare coverage, they will have a difficult time finding a physician who will provide care for them. Remember that many physicians are small business owners. When their expenses exceed revenue (as in the case of Medicaid), their businesses cannot survive—no matter how well intentioned.
All the new burdensome Obamacare regulations are already beginning to drive up physicians’ overhead costs. With its increasing bureaucracy, private-practice doctors say they will also need to hire more employees just to keep up with the “red tape”.
According to my husband, “One way the government can cut costs is by decreasing the number of patients that doctors can see each day. This is achieved by increasing the amount of time-consuming paperwork they have to complete on each patient.”
Not to mention the fact that as Washington D.C.-area orthopedic surgeon, Dr. Robert Nirschl argues, “Doctors must comply with a morass of paperwork requirements that adds no value to the doctor-patient relationship.”
Between the decreased reimbursements rates and increased regulations (and high malpractice premiums), many doctors question whether or not they will be able to keep their doors open once Obamacare is fully implemented. Dr. Robert Nirschl says, “Many physicians are talking about quick retirement, or cutting back or not participating in the practice of medicine.”
Obamacare may very likely result in doctor shortages in the very near future –which will also lead to problems with Americans being able to access medical care they need. So President Obama’s promise that “If you like your doctor, you can keep your doctor” is about as likely as being able to keep your current healthcare plan. Dr. Nirschl adds, “The problem is now they (patients) are stuck with either losing their health insurance, and of course, that affects a doctor’s practice because the patient comes in and says, ‘Well, I don’t have insurance anymore.’”
In fact, a medical doctor (and cancer patient), Shaun Carpenter, a board certified emergency physician in the New Orleans area, actually had first-hand experience of what it was like losing his own health insurance. From PJ media:
Add to hemochromatosis, which is now under control, Dr. Carpenter has been stricken with cancer twice. He suffered and beat both lymphoma and melanoma, in 2003 and 2005, respectively.
Obamacare, aka the Affordable Care Act, came packaged with lofty promises. President Obama said his law was supposed to make denials of insurance based on pre-existing conditions a thing of the past. President Obama specifically promised that Americans would no longer be denied coverage based on pre-existing conditions, along with promising that if we like our doctors and current health care plans, we can keep them.
So imagine Dr. Carpenter’s shock when he received the news that he and his family were losing their health insurance at the end of this year.
Of course, the president has now decided that Americans can keep their current health plan for another year (until after next year’s midterm elections).
“As a physician I’ve been opposed to Obamacare from the get-go,” Carpenter says. “It doesn’t begin to fix the real problems with our health care system, and creates new problems. I see it from both the private practice side and the ER side. In fact, we knew that when patients came into the ER without insurance they would actually get better care because we knew we had to run every test imaginable on them or risk getting sued.” The problem isn’t lack of health insurance, he says, but lack of health care. Just because you have insurance doesn’t mean you’ll get health care. Just ask anyone who has Medicaid how hard it is to get an appointment with a specialist. The wait can be several months, if you ever get in at all.’ That’s what Obamacare promised to make more accessible and more affordable.”
President Obama’s own cousin, Dr. Milton Wolf, even called Obamacare a lie. Dr. Wolf recently stated, “They call it the Affordable Care Act? But not a word of that is true. It’s not affordable and it does not provide care.
Dr. Wolf says his cousin is wrong about his signature piece of legislation. “He’s wrong,” Wolf says. “He’s wrong to think the government should step between a doctor and their patient.”
Many physicians also see Obamacare as socialism. In fact, retired Johns Hopkins University neurosurgeon, Dr. Ben Carson, explained how Vladimir Lenin once said that “Socialized medicine is the keystone to the establishment of a socialist state.”
Of course, Liberals will argue that Obamacare isn’t socialized medicine; single-payer is. However, as Dr. Nirschl writes:
Obamacare and single-payer are essentially the same…
The facts of the matter are that now physicians are now beholden to the policy of the government on the basis of Obamacare. Also, the insurance industry is beholden to the government. Whether or not the government merely becomes the insurance broker versus the government is the controller of a subsidiary insurance broker (which is private insurance companies). The facts of the matter are that the process is exactly the same. So, it is, in fact, socialized medicine.
The other issue is, of course, is that this is a huge transference of wealth. In other words, what is happening is that the Obamacare system (as it has now evolved and as the law states), what is occurring is that the productive folks who basically have their own private insurance are losing that insurance and in the process when they go back to the exchanges to get insurance, the prices are high because they are substituting their insurance and paying for those who basically pay nothing.
That is a mandatory contribution. All of that transfer from productive citizens, the transfer of wealth is socialism.
That’s why doctors will argue that Obamacare has little to do with health care and everything to do with control. Dr. Ben Carson even recently boldly claimed, “Obamacare is the worst thing to happen in this country since slavery…In a way it is slavery because it is making all of us subservient to the government. And, It was never about health care– It was about control. That’s why when this administration took office, it didn’t matter that this country was going off the cliff economically. All forces were directed toward getting this legislation passed.”
For doctors, this means that Obamacare has now certainly fundamentally transformed the way the treat their own patients. In fact, they are now being forced to do what’s best for the government as opposed to doing what is actually best for the patient. Under Obamacare, doctors are essentially becoming Slaves of the State.
…And the AMA says it stands by longstanding policy in support of individuals buying their health insurance coverage.
And just this week, the American Academy of Family Physicians, in a statement from its President Dr. Jeffrey Cain said the Affordable Care Act’s requirement that individuals have health insurance “is the foundation of improving access to care and vital to ensuring everyone has health care coverage.””
However, Mayo Clinic Chief Dr. John Noseworthy, claims, “Obamacare is Not Focused on Improving Quality of Care.”
It’s no secret that our pre-Obamacare health care system certainly had some serious problems. According to Physicians for Reform, two of the biggest problems include:
1. The bureaucracy of the current system that drives inefficiency and increased spending. This leads to massive overuse and waste.
2. The third-party payer system (whether Medicare, Medicaid or private insurance) blinds both patient and physician from the real cost of care. This disconnect removes the breaks that normally constrains spending in a free-market system.”
In many cases, Obamacare is actually making these issues much worse. Dr. John Noseworthy also says about the Affordable Care Act, “It doesn’t modernize how we drive to higher quality care. What’s missing is a link between quality of care and reimbursement. Correcting that could lower costs…Right now, we’re in a system where we’re reimbursing volume of care, not quality and outcomes of care — safety, efficiency and so on. And that’s where most of the costs are.”
It is very questionable whether or not Obamacare will ever be fully repealed. However, doctors at Physicians for Reform have already proposed patient-centered solutions in place of Obamacare:
- Stabilize Medicare for seniors. The Medicare cuts to physician reimbursement will severely compromise access for seniors unless a budget solution is found. Severe cuts can be prevented and paid for by fundamentally restructuring Medicaid. Converting Medicaid’s current system into a system of limited state block grants will save the federal government tens of billions of dollars annually. This savings can offset the massive Medicare cuts.
- Let individuals purchase insurance with pre-tax dollars regardless of where they purchase insurance. This increases the portability and lets individuals customize their policies.
- Encourage low cost, high deductible plans combined with a Healthcare Savings Account (HAS) for patients who are best served by this model. This model encourages preventative medicine while reducing the cost of healthcare.
- Let individuals and businesses purchase insurance across state lines to escape burdensome state regulations and mandates.
- Create small business pools to spread risk and decrease health insurance costs.
- Incentivize states to pass patient-centered medical malpractice reform.
- Create state-run, high-risk pools for patients with chronic disease.
- Put the Medicaid program on a budget and develop a sliding scale, premium support system to assist those who cannot afford health insurance. This accomplished three things: 1. It enables states to create fixed Medicaid budgets. 2. It empowers individuals in this system to purchase private coverage that best suits their needs. 3. It creates opportunity for individuals on Medicaid to exit the system by gradually increasing their income.
- Put Medicare on a budget and restructure Medicare with a premium support system where seniors can choose from a variety of competing plans. The system is structured so that those who have fewer financial resources or more medical need receive more support. This reform empowers individuals to purchase the private coverage that best suits their needs. It would also dramatically reduce the tens of billions of Medicare fraud by giving seniors an incentive to get the best value for their healthcare dollar.
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