Yet attracting and retaining doctors is critical to the health of our medical system and to serving patients' needs. Many Americans may assume that relatively high pay will be enough to keep doctors in the profession. But doctors’ “high pay” should be kept in perspective: Medical doctors go for years without any pay while in medical school (which is expensive). During residency, they must work long, undesirable hours. Then they enter the profession, and because of today’s messy tort system, they must pay for pricy malpractice insurance, which eats into their earnings. These highly intelligent individuals have many other ways to earn money outside of the medical field, and will opt to do so if medicine becomes a less attractive option.
Doctors’ opposition to ObamaCare is likely as much due to what the legislation didn't do, as it is to what it did wrong. ObamaCare didn’t reform tort law, which contributes to the high cost of health care by driving defensive medicine and keeping malpractice premiums high for doctors. It didn’t fix the Sustainable Growth Rate formula, which determines how much Medicare pays for services physicians provide. In fact, ObamaCare intentionally left the so-called “doc fix” out because it would have added to the bill’s costs. But cuts to Medicare reimbursements are still scheduled each year, and doctors will have to wait on Congress to determine how much they will or won’t be paid to see their elderly patients.
In addition to ignoring some existing problems in the health care system, ObamaCare will actually worsen other problems for doctors. ObamaCare will add 18 million people to Medicaid, which on average reimburses doctors only 56 percent of the market rate. Sixty percent of doctors are already considering a move to stop accepting government health programs. This is bad news for patients who were promised “easy access,” but it's hard on doctors as well, who entered the profession to help the sick, not to have to turn them away.
ObamaCare also inserts an unprecedented amount of government bureaucracy into the work that doctors do. You’ve probably already seen the ObamaCare flow chart with a thousand arrows. Where do you think doctors fit into that mess?
Here are a few places: The Physician Quality Reporting Program means (even) more paperwork for doctors. The Independent Payment Advisory Board will attempt to reduce government spending on Medicare, essentially through price controls. This will make it more difficult for Medicare patients and their doctors to access the right treatments. The “non-profit” Patient-Centered Outcomes Research Institute will gather information on comparative effectiveness in patient outcomes, which may ultimately dictate which treatments doctors must prescribe. It's unknown just how much doctors' choices will be limited, but doctors naturally fear their loss of autonomy.
So next time you visit your family physician, or your optometrist, or your neurosurgeon, ask how he or she feels about the health reform. Ask if he or she favors repeal. In most cases, the answer will be yes.
Congress shouldn’t ignore input from doctors on health policy. Repeal is the right prescription.
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