Friday, April 12, 2013

Does Obamacare Do More  Harm Than Good?
First, do no harm.
Hippocrates (c.460-377 BC)

When I do good, I feel good.
Abraham Lincoln (1809-1865)
“If,” is a word to watch in health reform.

From Physician’s Point of View, Reform Does more Harm Than Good If..

·         It distracts from or interferes with doctor-patient relationship.

·         It burdens physician swith unnecessary rules and regulation.

·         It consistently overrides physician decisions.

·         It threatens to cut physician  Medicare pay each year through SRG formula.

·         It takes no action of malpractice reform.

·         It violates doctor-patient confidentiality.

·         It forbids private doctor-patient private contracting outside of Medicare.

·         It increases physician legal compliance obligations and liability under federal fraud and abuse statutes, encourages whistleblowers, and suspends government’s need to prove “intent’.

·         It forces physicians to consolidate with other practitioners, become hospital employees, or align with hospitals or health systems for capital, administrative, and technical resources.

·         It considers “bigger” is always “better”.

·         It raises the cost of health care in general and health plan premiums in particular.

·         It compels physicians to install and finance electronic health records for the purpose of physician surveillance.

·         It abuses electronic data to judge physician performance and to pay for that performance.

·         It encourages patients to switch doctors and health plans.

·         It judges physicians but not government, as “accountable” and solely responsible for rising health costs.

·         It appoints an outside non-elected “independent, but presidential, board to decide how and what physicians should be paid.                      

From Government Reformers’ or Do Gooders’ Point of View, Reform  Does More Good Than Harm If…

·         It lowers cost of care compared to other nations.It enhances federal power and oversight.
·         It widens access to care to the uninsured and subsidizes care of  those four times below the federal poverty line.

·         It raises quality of care as determined by outcome data.
  • It covers or makes “free” cost of care for children,  young adults under parents plans,  preventive tests for Medicare recipients.

·         It protects  seniors from failling into the prescription “donut hole.”

·         It prevents  insurers from no longer imposing  an annual or lifetime limit on policyholders’ benefits.
  • It declares health savings and flexible savings accounts funds can no longer be used to pay for over-the counter drugs.
·         It does not allow insurers to deny coverage for pre-existing illnesses.

·         It forces insurers to rebate portions of premiums that exceed 80% of marketing or administrative costs.

·         It forbids insurers or compels them to justify raising premiums too much in any given year.

·         It changes the way doctors are paid from fee-for-service to bundled bills for procedures,  population groups, or episodes of care.

·         It says all insurers must cover “essential health benefits” and approved preventive tests) as of September 2010.

·         It compels every individual who does not buy health insurance to pay a maximum penalty of $285 a year in 2014,  $795 in 2015, and $2085 in 2016.
  • It says Independent Payment Advisory Board (IPAB) cn begingnmaking recommendations to cut Medicare spending  in 2015 and implement these recommendations in 2018.

  • It begins to tax “Cadillac” health plans by 40% of value on 2018.

Tweet: With health reform,  harm comes with good. It is question if government benevolence does  more harm than good and of unintended consequences.

No comments: