Health Reform Law - Raw Deal for Physicians

I pledge you, I pledge myself, to a new deal for the American people.

Franklin Delano Roosevelt (1882-1945), Speech accepting Presidential Nomination, July 2, 1932

“Big F----ing Deal.”

Joseph Biden (born 1942), 47th Vice-President of the United States, comment on signing of health reform law, March 23, 2010

March 21, 2012 - A deal is usually thought of as an agreement, arrangement, or transaction, that benefits all. There are New Deals, Fair Deals, Square Deals, Sweet Deals, Big “F---ing” Deals, Small “F—ing” Deals, Bad Deals, Good Deals, and Raw Deals.

In minds of physicians, the Health Law Reform Deal, falls into the “Raw Deal “ category – an unfavorable deal. It is unnfavorable not only for themselves but for taxpayers and patients because, among other things, according to an estimate last week by the Office of Management and Budget, it will cost $1.76 trillion rather than the original estimate of $940 billion.

In a survey of 60,000 physicians conducted by the Physicians Foundation in 2010:

• Most physicians (67%) were either “somewhat negative” or “very negative", about the health law.

• Most physicians (54%) thought the law would increase their patient load.

• Most physicians (68%) said the law would decrease the financial viability of their practices.

• Most physicians (59%) thought the law would cause them to spend less time with patients.

• Most physicians (74%) said they would not be able to practice as usual over the next 3 years.

• Most physicians (51%) said they would close their practices to Medicaid patients, or significantly restrict access to Medicare patients (57%)

Most physicians, in other words, thought of the Affordable Care Act as a “raw deal.” This should surprise no one, nor should the consequences.

A recent survey by the Doctors Company, the nation’s largest malpractice carrier, revealed that 90% of doctors would not recommend medicine as a profession, and 43% said they were contemplating retirement within 5 years.

Adding to the gloom are these realities.

• Congress is unwilling to fix the SGR formula, which was modestly adjusted this year but which will call for a 32% cut in Medicare physician fees in 2013 because it would result in a $330 billion boost in Obamacare costs.

• The ACA calls for a $575 billion cut in Medicare, most of which will come off the hide of physicians and hospitals. Hospitals are to be cut by $52 billion and physician Medicare fees are projected to be below those of Medicaid by 2019.

• A deal on national tort reform is unlikely because a huge Democratic contributor, the trial lawyers group, the American Association of Justice, declares national tort reform a political no-no.

• Obama and his political base adamantly oppose incremental market-based reforms, such as shopping across state lines and unfettered health savings accounts, which would rely on sensible bottom-up consumer intelligence and judgment rather than sweeping top-down, dumbed-down decision making.

• Independent physician practices are in sharp decline as physicians find themselves unable to deal economically with reimbursement declines, practice costs raises, regulations, rules, protocol, and electronic record distractions that pull them away from patients, their main source of income.

Tweet: Most physicians regard the health reform law, now about to celebrate its 2nd anniversary, as a “raw deal” for themselves, taxpayers, and most American citizens.