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  • Obamacare: A Hard Pill to Swallow for Physicians

    The negative effects of Obamacare will impact every American.  However, it is those who are the very backbone of the United States’ high-quality health care system who will be most severely affected: physicians.  In a recent paper, Heritage’s health policy expert Robert Moffit, Ph.D., details the changes American doctors can expect to see in the way they practice medicine as a result of the recently-passed law.

    Moffit outlines the following as being most detrimental to the practice of medicine:

    Medicaid Expansion and Payment. As it is, doctors receive heavily reduced pay for treating Medicare patients, and reimbursement for Medicaid is even lower.  In many areas, doctors who accept Medicaid do so at their own loss, as reimbursement rates do not even cover the expense of seeing the patient.  Writes Moffit, “Medicare payment

    has resulted in sporadic access problems for Medicare patients, and the lower Medicaid payments have already contributed to serious access problems for low-income persons and worsened hospital emergency room overcrowding.”  By adding an estimated 18 million people to this system, Obamacare will aggravate these existing dilemmas.

    The Sustainable Growth Formula. Physician payment formulas under Medicare are tied to growth in the general economy, rather than medical inflation.  This means every year, the law requires cuts in doctors’ reimbursement rates.  However, each year Congress votes to suspend these cuts to avoid the unquestionable impact they would have on access to physicians for Medicare beneficiaries.  According to Moffit, “The new law provides no SGR fix. Moreover, Congress has shown no inclination to fix the broken SGR formula without adding to the federal deficit rather than embracing fiscal discipline and embarking upon a genuine reform of the Medicare program.”  Under Obamacare, doctors will continue to face the threat of this broken payment system undermining their ability to treat senior citizens.

    More Bureaucracy. Government regulation and oversight of medicine will reach new levels.  The Patient-Centered Outcomes Research Institute will conduct comparative clinical effectiveness research on treatments—the way in which this information is used will determine its effect on the practice of medicine.  The new Independent Payment Advisory Board will be charged with reducing growth in spending in Medicare—though their options are limited mainly to imposing further price controls.  And the extension of the Physician Quality Reporting Program will mean more time-consuming paperwork for doctors.

    The effects of these provisions on the practice of medicine are serious.  Writes Moffit, “…ominously, with America already facing a shortage of physicians, particularly in geriatrics and primary care, many physicians also say they would leave the profession.”

    To protect the quality of the U.S. health care system and access to its physicians, Congress should repeal Obamacare and start again with health care reform that strengthens—not dissipates—the doctor-patient relationship.

    Posted in Obamacare [slideshow_deploy]

    13 Responses to Obamacare: A Hard Pill to Swallow for Physicians

    1. Meghan, Alabama says:

      The absence of an SGR fix and medical liability reform make it very clear that this health care bill has nothing to do with reforming health care. This health care bill is little more than a power-grab by the Democrats over a sizable portion of our economy.

      The SGR must be addressed, and any fix should take into account both the number of people on Medicare and the actual market cost of procedures. Currently, the formula leaves those factors out.

      • @charlaine50 says:

        Totally agree and very articulately put. This has been broken for some time and ignored. This bill only added paperwork to already overburdened system with paper. It takes 10 clerical staff to follow documentation requirements for 1 physician at my primary care doctor's office. I was in homecare for 20 years and saw the documentation demand increase while reimbursement decreased. I am not an expert in economics, but anyone who can add will see that this formula does not work.

    2. Evelyn Gurskey Eldor says:

      I think that Obama Care will allow older Americans to die rather than be able to get medical care. I am one of those Senior Citizens. I can't afford the medicines that I need now. Money is short each month.

    3. Barbara Frances Delo says:

      Absolutely!!! And how serious a problem is it??? Very – because what it means is that care will go down…doctors will become so overburdened with paperwork and cost saving time-limits that they will not have the patient time to provide good care. As a medical professional I know how discouraging it is to not be given the time and tools to really be able to take good care of my patients!!1

      In addition…care will go down because in every version I have seen…there is a shift from funding for doctors to funding for Nurse Practitioners and PA's. Nurse Practitioners and Pa's are very nice people…but remember they have about 1/2 the years of training that a MD has.

      • @charlaine50 says:

        NP and PA are able to treat some things, but complex and some acute conditions require the expertise of the MD. When I am ill, and I have chronic conditions, I need my MD. If it is a small sinus infection, the NP is fine. The NP can monitor when the condition has become stable. These people are labeled as physician extenders for a reason. They extend but do not replace the services of the MD. I do not think the public is aware of when it is appropriate for who to provide care.

    4. Adam F. Dorin, M.D., says:

      Agree 100%. That's why I recently created the website
      http://www.PhysiciansAgainstObamacare.org to help give voice to the silent majority of docs (and citizens in general!) who are so strongly opposed to Obamacare.

      I'm also coordinating with several conservative, non-AMA affiliated, medical groups to put on a Doctors' Tea Party event in San Diego on August 7th, 2010.

    5. M Party, Florida says:

      teapartybell.com picks this as the top article on healthcare reform today.

    6. Pingback: CBO Fans The Spending Debate – Blog Watch

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    8. Ben, Washington DC says:

      Physicians spend about 40,000 hours training and over $300,000 on their education, yet the amount of money they earn per hour is only a few dollars more than a high school teacher. Physicians spend over a decade of potential earning, saving and investing time training and taking on more debt, debt that isn’t tax deductible. When they finish training and finally have an income – they are taxed heavily and must repay their debt with what remains. The cost of tuition, the length of training and the U.S. tax code places physicians into a deceptive financial situation.

      See my article: The Deceptive Income of Physicians. http://benbrownmd.wordpress.com/

      • @charlaine50 says:

        The public does not realize that physicians are employers in a small business. They have clerical, nursing, and medical assistants. They must pay these people along with the utilities, office rent, malpractice insurance, and other small business expenses. People have to understand that when a physician starts an office, he becomes a small business. Reimbursement needs to keep that in account instead of this notion that doctors are rich people. Fewer people are able to become small business owners now due to government policies.

    9. Rob, Ames says:

      "Physician payment formulas under Medicare are tied to growth in the general economy, rather than medical inflation."

      Anyone wondering WHY medical inflation is so much higher than inflation in the general economy? The system is broke. "Just say no" is not a solution.

    10. Pingback: Obamacare: The Real Price Tag is a Moving Target — Let's Change America

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