Thursday, March 28, 2013

The Dysfunctional Relationship between Government and Doctors
The element of a plan, law, strategy, or system that fails to perform as expected and disrupts or threatens to disrupt some or all of the other elements.
Definition of Dysfunctional
To say that Obamacare is dysfunctional as we move towards  full implementation in 2014  is an understatement. Yesterday’s announcement by the Society of Auditors that Obamacare would raise overall costs by 32% by 2017 underscores the dysfunctionality.
Nowhere is this dysfunction more evident than in the relationship of the Obama administration and physicians. A headline  in yesterday’s Wall Street Journal “Warning Over Doctor-Run Groups” is an example.  The article warns of physician groups owned by orthopedic and spine  surgeons  that serve as intermediaries between medical device manufacturers and hospitals.  The Inspector General calls these groups “inherently suspect” and warns they “pose dangers to public safety.”
This is not the first time a government agency has gone up against physicians.    It did so when Congress shut down fthe building of future physician-owned hospitals.  It does so when it prints 1600 pages of more regulations and piles them upon an already over-regulated health care industry.  It does so when it threatens to imprison doctors or suspend their licenses if they do not follow Medicare compliance rules to the letter.  It does so when it  forbids doctors from privately contracting with patients.  It does so when it requires doctors to prescribe electronically and to install expensive electronic health systems at a loss with no hope for a return on investment.  It does so when it ascribes tremendous increases in cost of care  (now 18% of GDP) to fee-for-service medicine by accusing  physicians of greedily  increasing their incomes based on volume rather than quality.  It does do when it funds Obamacare partly by systematically reducing physician incomes at every turn over the next decade.
What are the results of this dysfunctional relationship?
A White Paper published by an advisory panel of the Physicians Foundation “Health Reform and the Decline of Physician Private Practice” sums it up nicely.
·        “Reform will drastically increase physician legal compliance obligations and potential liability under federal fraud and abuse statues.”

·        “Most physicians will be compelled to consolidate with other practitioners, become hospital employees, or align with large hospitals and health systems for capital, administrative and technical resources.”

·        "Reform will exacerbate physician shortages, creating access issues for many patients.”

Government is looking for a villain outside of government, and they have found it in physicians.  “Trust, but verify",  Ronald Reagan’s old saying for dealing with the evil empire has become “Distrust, but deny and  comply.”  This may be a winning strategy but it has one glaring problem: Patients trust their physicians more than government.

Tweet:  A dysfunctional relationship exists between government and physicians who distrust each other’s motives.


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