While much has been said about the recently passed health care overhaul law and a multitude of cogent arguments have been made as to why the legislation must be repealed, lengthy debates have failed to adequately address how the 2,800 pages will prevent patients from receiving the medical care that they need and want. In fact, in some ways the federal government already hinders the ability of doctors to provide their patients with good care. These trends will no doubt worsen under PPACA. In addition, new regulations and mandates will place unaccountable regulators in between physicians and their patients.
Medicare’s physician reimbursement regimen is fraught with underpayments and perverse incentives. During the health care debate, supporters of PPACA praised Medicare’s ability to exploit its size to obtain lower fees with providers. While it is true that Medicare can bludgeon down physician fees, this is not one of the program’s greatest strengths, but actually one of its greatest weaknesses. These underpayments are ultimately shifted to patients in the form of shorter visits, less doctor face time, quick hospital discharges, and compromised care. Rather than reforming the government’s flawed reimbursement regimen, PPACA merely expands its scope to more people.
PPACA establishes the Patient-Centered Outcomes Research Institute to conduct research comparing the efficacy of medical and surgical interventions. The potential harm from this depends how it is used.
Federal regulators could easily use this research to ration care by financially punishing physicians prescribing these “less effective” treatments. This research coupled with reimbursement changes could easily pave the way for the government dictating to patients the medicines, tests, and procedures that they can and cannot have, regardless of willingness to pay and personal preference. This would replace the professional judgment of physicians with rigid rules set by regulators in Washington DC. This one-size-fits-all approach will limit choice and result in poor quality care.
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