Obamacare Repeal Will Not Reverse Reform Pressures

September 9, 2011 - I received this September 8 e-mail from Doctor Donald J. Palmisano’s DJP Update.

“Now we have heard from the Sixth Circuit(2:1 say PPACA constitutional): Eleventh Circuit(2:1 say individual mandate unconstitutional); and today the Fourth Circuit (Dismissed for lack of jurisdiction… the case will go to the Supreme Court. I predict it will be heard in next session of Supreme Court, and we will know decision by end of June or sometime in July 2012. And now, I know I repeat myself; individual mandate and most likely the entire PPACA (lack of severability clause) will be ruled unconstitutional. Uncertainty is destroying practice of medicine. That is my opinion).”

I respect Dr. Palmisano’s opinion. He is a lawyer as well as a surgeon.

But, you opponents of Obamacare, don’t get your hopes up. Life for physicians will never be the same again. We will not return to the status quo.

As a group of analysts assembled by the Physicians Foundation in 2010 observed in a 73 page White Paper, Health Reform and the Decline of Private Practice,

“This time, reform will not be a ‘false dawn,’ analogous to the health reform movement of the 1990s, but will usher in substantive and lasting changes…Most physicians will be compelled to consolidate with other practitioners, or align with large hospitals and health systems for capital, administrative, and technical resources.”

There will be no return to yesteryear. Societal and economic trends to lower costs and restructure practice will continue unabated. These will include pressures to install EHRs, curtail high tech procedures, lower specialists’ fees, end fee-for-service, consolidate care and coordinate care, comply with rules and regulations, monitor care, and calls for improved quality, real or imagined.

Tweet: The Supreme Court will probably hear Obamacare case in summer of 2012. Even if overturned, its measures will still bedevil physicians