OBAMACARE AND ITS IMPACT ON DOCTORS
June 17, 2010
Don't expect doctors to give ObamaCare a clean bill of health. The act will reinforce the worst features of existing third-party payment arrangements in both the private and public sectors -- arrangements that already compromise the professional independence and integrity of the medical profession, says Robert E. Moffit, director of the Center for Health Policy Studies at the Heritage Foundation.
Under the new law, an estimated 18 million of the 34 million who would gain coverage over the next 10 years would be enrolled in Medicaid, a welfare program jointly administered and funded by the federal government and the states. Such a massive Medicaid expansion will displace private health coverage, and expand government control over health care financing and delivery, says Moffit.
- Medicare physician payment is annually updated on the basis of the Sustainable Growth Rate (SGR) formula, which ties annual physician payment increases to the performance of the general economy.
- Under the SGR, without congressional intervention, the initial Medicare pay cut would amount to 21.3 percent.
The impact is not hard to fathom, says Moffit:
- For example, the Fairfield County Medical Association in Connecticut reported that if such cuts were to take effect, 41 percent of county doctors would stop taking new Medicare patients and nearly one out of four doctors would drop Medicare altogether.
- Congress has shown no inclination to fix this problem without adding to the federal deficit, and thus can be expected to continue resorting to stop-gap measures to stop its own Medicare payment formula from actually going into effect.
On top of existing payment rules, regulations and guidelines, the new law creates numerous new federal agencies, boards and commissions. A key goal of health care reform should be to restore the traditional doctor-patient relationship. In such a relationship, doctors would be the key decision makers in the delivery of care, and patients would be the key decision makers in the financing of care. This cannot be achieved unless and until patients control health care dollars and decisions, and third party insurance executives are directly accountable to those who pay the health care bills, says Moffit.
Source: Robert E. Moffit, "ObamaCare and its Impact on Doctors," Physicians News Digest, June 14, 2010.
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