June 12, 2012
Who Will Provide My Health Care?By Deane Waldman
Whom do you want to operate on your heart: a doctor or a bureaucrat? This scenario is neither a joke nor an exaggeration. Two trends happening right now make it likely that the person who will provide your health care will have a BA or MBA after his name rather than "MD" or "RN."
Trend 1: Losing doctors
Doctors are increasingly refusing to see government-insured -- viz., Medicare -- patients, or leaving medicine altogether. With our government attacking our doctors, why should they keep seeing government-insured patients? And the word "attack" is truth, not hype.
Imagine you are a doctor. You help a sick patient and bill for your services. The government pays whatever it wants -- a small fraction of your bill. Worse, it continually reduces these payments, now below your cost to stay in business. The ACA (Patient Protection and Affordable [hah!] Health Care Act, or ObamaCare) spends over $1 trillion on bureaucrats, taking it from doctors, and thereby reducing patient care.
You are still the doctor. You spend your time and energy trying to follow an ever-increasing number of rules and staying within regulatory compliance, instead of seeing your patients or thinking about their care. You constantly cry, "Please, government! Stop piling on useless and harmful regulations. Stop telling me what I can do and what I cannot. Stop practicing medicine. Leave that to doctors!"
Now you are a patient. Though most doctors and nurses do very well for you, some patients have bad outcomes. In one second, the same care provider you trusted to open your chest and fix your heart instantly becomes the root cause of all your suffering.
Why would doctors continue working in a world where they get paid less than truck-drivers, where they are saddled with an ever-mounting mass of useless red tape, and where their title can instantly change from "doctor" to "perpetrator"? Answer: they wouldn't.
While prior surveys have shown similar trends, a recent poll of U.S. doctors gives a new and louder clarion call: doctors are becoming an endangered species. When you view the survey results below, keep in mind what President Obama promised the American people when he pushed through the ACA. "If you like your doctor, you can keep your doctor."
o ACA provisions and other regulatory controls make 83% of doctors consider quitting medicine.
o 61% say that government rules are making it impossible to follow the Hippocratic Oath.
o 65% of physicians think that the #1 reason for the deterioration in the quality of health care in the U.S. is "government involvement."
o A spectacular 85% think government regulations impair the doctor-patient relationship.
o "How will you respond to lower payments from Medicaid or Medicare?"
- Stop seeing new Medicaid patients: 49%
- Stop seeing new Medicare patients: 42%
- Stop seeing patients entirely or retire: 33%
Still think I was exaggerating about there being no doctors? Lest you think this is all about money or prestige, ask yourself: who makes decisions about my health care?
Trend 2: Increasing government control of health care
The doctor is held responsible for a patient's outcome. Is the doctor in control of that outcome? The answer is a resounding No!
Imagine that your doctor knows that drug A is the best medicine for you. The government pays only for drug B. Which drug will you get? Who is in charge of your health care?
Your doctor wants to refer you to the specialist with the best track record of outcomes for patients with your condition. The government insurer tells the doctor to send you where the cheapest contract is. That is the only referral the government will authorize.
Is the doctor in control? Of course not. A government bureaucrat is in charge and is practicing medicine, yet the doctor is held responsible for the outcome.
Right this minute, the ACA is creating a new federal agency called IPAB (Independent Payment Advisory Board). IPAB will decide what treatments will be authorized (paid for) and which will not. Effectively, they are practicing medicine by telling the doctor what she or he can and cannot do.
IPAB decisions will presumably be made on what the Panel thinks (without public oversight) is best for the whole population, not what is best for you. This has led in every universal health care country to strict government rationing -- government control of the practice of medicine.
So just like the money, the control issue is driving providers right out of health care. The ACA reform of health care is exacerbating (opposite of reform) an already critical doctor shortage. Are you sure you want your congressional representative's staffer to operate on your heart?
When will We The Patients -- that's you -- rise up and speak out in your own best interest? Shout, "Federal government, listen to me! Stop attacking the people whom I need to help me! When my belly hurts, I need a doctor or nurse with years of experience, not a 26-year-old paper-pusher with a big book of regulations."
This is a paraphrase of an old but powerful truism. They came for the Jews, but I wasn't Jewish, and so I said nothing. They came for the blacks, but not being black, I remained silent. They came for Hispanics, but that is not me, so I stayed out. They came for the doctors, and not having an M.D. degree, I turned a blind eye. Now I need health care. Who will provide it?
FOLLOW US ON