Jason Fodeman

The soon-to-be established health insurance exchanges will also give the federal government vast new control over physician practices. PPACA states that starting January 1, 2015, a qualified health plan can contract with a provider “only if such provider implements such mechanisms to improve health care quality as the Secretary may by regulation require.” Depending on the guidelines, this gives the federal government unprecedented new authority over not just those physicians accepting Medicare and Medicaid, but any provider accepting any third party payer offered through the exchange. Of course quality care is a good thing, but who should determine the definition of “quality?’ Who knows best? This regulation seems to be based on the notion that bureaucrats at HHS from afar know better than the doctor actually talking to and examining the patient. This will coerce physicians to practice medicine not the way they were taught, but the way the government tells them. Ultimately, this too will lead to poor quality, standardized care and restrict choice.

PPACA will strip away physician autonomy, drown doctors in bureaucracy, and drain job satisfaction. As the profession deteriorates, older doctors will retire while younger doctors will look to switch careers. Many young people considering a career in medicine will pursue other opportunities. The supply of providers will dwindle as demand for services reaches an all-time high. Ultimately, the consequences of the health overhaul law will be passed along to patients through restricted access, long wait for appointments, and rationed care.

The United States boasts the world’s premier health care system. With that said, of course there is room for improvement and efforts must be implemented to control spiraling costs. A better prescription for reform would be to build off the success of the current system while targeting its inevitable shortcomings.

Ultimately, there are only two ways to lower costs. One approach empowers bureaucrats to make tough decisions for doctors and patients. This has grave ramifications on quality of care and choice.

Unfortunately, the administration chose to pursue this route. Yet, patients would be better served if doctors were held more accountable by transparency and choice, rather than bureaucratic fiat. A more practical approach to lowering costs empowers and incentivizes patients to be smarter health care consumers. This entails solutions such as expanding health savings accounts, creating a national market for health insurance, and leveling the tax playing field. These could bend the cost curve down while simultaneously strengthening the patient-doctor relationship.

The time has come for a long-overdue, honest discussion on not just the impact that government will have on patients, doctors, and the practice of medicine, but the impact it already has had over the past forty-five years. The importance cannot be undersold as the Patient Protection and Affordable Care Act is indeed bad for doctors, but it is always the patient that suffers the most.


Jason Fodeman

Jason D. Fodeman, M.D. is an Internal Medicine Resident at UCONN and a former health policy fellow at the Heritage Foundation.