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.