Sunday, July 22, 2012

Is the Affordable Care Act Good or Bad News?  
Do you want the good news or the bad news first?
Frequently asked question
July 22, 2012  - It depends upon whom you ask and about whom you are talking about.
If you ask Obama supporters,  the Affordable Care Act is good news.   It covers 30 million more uninsured Americans. It subsidizes at least 20 million more underinsured with family incomes up to $88,000   It  partially plugs the donut hole.  It says it will offer free preventive checkups.  It provides coverage for those with pre-existing illness and young adults up to 26 under their parents' plans.  It promises (but so far has failed) to  contain costs.  It organizes disorganized doctors. It controls state spending.   It puts government in the health care driver’s seat. And  it implies, in one way or another, that government experts, not the people, know what good for most of the people most of the time.
If you ask seniors,  about 2/3’s  will give you  a bad news  answer.  Obamacare cuts some 11 million seniors out of Medicare Advantage plans.  It slashes $550 billion out of Medicare with the promise of improving care while cutting costs – a trick government has never accomplished in its history. 
If you ask taxpayers and the middle class, they will  be leery, which is why the majority favor repeal by margins of 10% to 12% since passage of the health reform law.   Obamacare will increase taxes by over $500 billion and will impose a 3.8% Medicare surcharge.
If you ask doctors,  the news will be received negatively  about  67% of those in active practice.    The exact percentage will become evident in an E-survey of 675.000 doctors just completed by the Physicians Foundation and due to be released soon.
If you ask the Heritage Foundation, a conservative think-tank, you got this answer, in a June 22, 2012, press release “Top Five Reasons Obamacare Is Bad for Doctors,”  which concluded:
,No class of American professionals will be more negatively impacted by Obamacare than physicians.”
  1. “Adds more patients to Medicaid. Beginning in 2014, Obamacare dumps an additional 19.6 million Americans into Medicaid. On average, Medicaid physician payments are only 56 percent of what private insurance pays. Lower payment rates already discourage doctors from accepting Medicaid beneficiaries, which has lead to access issues and hospital emergency room overcrowding. As more patients enroll in this broken program, it will place even more financial strain on physicians who treat them. Doctors will be faced with the decision to either discontinue treating Medicaid patients or accept even more patients at the lower payment rate.”
  2. “Leaves the flawed Medicare payment formula on the books. Every year, doctor payments face the threat of deep cuts due to the Sustainable Growth Rate formula, which governs the growth of Medicare physician payments from year to year. But it’s well known that such drastic provider payment cuts would harm seniors’ access to care, and Congress has passed a last minute “doc fix” each year since 2003 to avoid this. Still, an estimated payment reduction of 27 percent is scheduled to go into effect next year unless Congress passes another doc fix, which will cost an estimated $208 billion. This problem faces doctors and Congress every year, and Obamacare does nothing to solve it.”
  3. “Creates a new board to further cut provider payments. Obamacare uses the Independent Payment Advisory Board (IPAB), a board of 15 unelected bureaucrats, to contain cost growth in Medicare by finding ways to cut spending to meet a new budget target. The board is limited in how it can achieve its goal, but one avenue definitely available is to further ratchet down provider payments. As IPAB cuts reimbursements, seniors will experience growing access problems as doctors discontinue seeing Medicare beneficiaries. If IPAB elects to limit seniors’ access to certain treatments and services—which is also within its abilities—patient choice and physician autonomy will also be sacrificed.”
  4. “Exacerbates future physician shortage. America is projected to face a shortage of 91,500 doctors in 2020. Meanwhile, many surveys have concluded that American doctors have a negative view of Obamacare and its impact on the medical field. One survey found that Obamacare is motivating 43 percent of doctors to move up their retirement within the next five years. This will intensify the already existing doctor shortage.”
  5. “Destroys the doctor-patient relationship. Obamacare’s massive amount of red tape and regulations will tear apart the doctor-patient relationship. Doctors will have to focus increasingly on government rules rather than the specific needs of their patients. Heritage’s Bob Moffit warns that Obamacare’s great expansion of government coverage will make physicians “increasingly dependent on unreliable government reimbursement for medical services.” In addition, Obamacare links payment for providers to adherence to government measurements of care. A recent doctor survey found that 67 percent of doctors surveyed said Obamacare would not improve the doctor-patient relationship.”
Tweet: Obamacare is bad news for doctors. It increases Medicaid load,  decreases overall pay to Medicaid levels, and exacerbates doctor shortages.

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