Doctors Give the Practice of Medicine under Obamacare a Grim Prognosis

On Monday, The Heritage Foundation hosted a panel of current and future physicians to discuss the impact of Obamacare on their profession. Their remarks highlighted the importance of the doctor-patient relationship as the heart of the practice of medicine and detailed direct threats as a result of the new health law.

Representative Michael Burgess, M.D., (R-TX) explained that part of being a physician is fighting for the best interests of each individual patient. Under Obamacare, this will be harder to do, as government inserts itself further into the provision of care. One example is the creation of accountable care organizations (ACOs) in Medicare. Representative Burgess pointed out that under ACOs, doctors would not be held accountable to patients, but rather to the hospital or health plan in charge. Based on his experience as an OB/GYN, Representative Burgess argued that it will be more difficult for doctors to stand up for patients’ needs to insurers or the government if they work directly for the latter.

Dr. Martha Boone, a urologist from Atlanta, further argued that currently, if an insurer denies coverage for a certain treatment, she can call the medical director (a fellow physician) and explain her rationale. In the case of coverage provided by the government, such as Medicare and Medicaid, that’s not an option—the answer is always no. Greater government influence in medical decision-making will come at the expense of patients’ own desires.

Physicians’ concerns go beyond the expansion of bureaucratic power into patient care. Jeet Guram, a first-year medical student at Harvard Medical School, pointed to the new law’s expansion of Medicaid, a flawed program, to cover an additional 18 million Americans. Since Medicaid pays physicians significantly lower rates than private insurance or Medicare, it is difficult for doctors to accept Medicaid patients without risking insolvency. As more Americans enter the system, barriers to access for Medicaid beneficiaries will become even more pronounced.

Of further concern to Guram is Obamacare’s “misalignment of priorities” when it comes to medical innovation. The new law increases government control over cost and utilization of services, which could distort demand. Further discouraging innovators are the law’s new taxes on pharmaceutical and medical device manufacturers. As Representative Burgess said, investors “don’t hazard big things for small rewards.” Medicine is on the cusp of exciting new territory, but discouraging future innovation could change that.

The sentiments expressed by the panel echo those of the medical profession at large. According to a recent survey sponsored by Pfizer, 59 percent of physicians cited the interference of non-medical entities in medical decisions as a negative development in the health care system. And 50 percent held an unfavorable view of Obamacare, compared to 24 percent who saw it as favorable.

Threats to the doctor-patient relationship existed before the passage of Obamacare. However, rather than empowering doctors and patients, the new law will result in further erosion as a result of government intrusion in health care.

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