The New Health Law: Bad for Doctors, Awful for Patients
By JASON FODEMAN, MD
April 2011
Galen Institute
While much has been said about the Patient Protection and Affordable Care Act (PPACA), lengthy debates have failed to adequately address the impact that the 2,800 pages will have on doctors, patients, and the practice of medicine. This Galen Institute white paper does just that. This paper examines in detail how the government already hinders physicians’ abilities to provide good care for their patients and how these harmful trends will only worsen under PPACA.
Medicare’s physician reimbursement regimen is fraught with underpayments and perverse incentives. During the health care debate, supporters of PPACA praised Medicare’s ability to exploit its size to obtain lower fees with providers. While it is true that Medicare can bludgeon down physician fees, this is not one of the program’s greatest strengths, but actually one of its greatest weaknesses. These underpayments are ultimately shifted to patients in the form of shorter visits, less doctor face time, quick hospital discharges, and compromised care. Rather than reforming the government’s flawed reimbursement regimen, PPACA merely expands its scope to more people.
Health care is currently one of the most regulated industries in the country. Doctors already devote a significant amount of their day to detailed documentation, paperwork, and signatures. This takes away from potential time doctors can spend at the bedside with their patients. These requirements are likely to increase under the health overhaul law. New regulations will place unaccountable bureaucrats in Washington, D.C., between physicians and patients and grant these regulators unprecedented control over medical decisions. While this will no doubt be frustrating for doctors, it will be the patient facing limited access and 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 students considering a careering 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 health overhaul law will be passed along to patients through restricted access, long wait for appointments, and rationed care.
The Patient Protection and Affordable Care Act is indeed bad for doctors, but it is always the patient that suffers the most.