Tuesday, June 26, 2012

Why Doctors Dislike Obamacare
Please do not
Annoy, Torment
Pester, Plague,
Molest, Worry,
Badger, Harry,
Harass, Heckle,
Persecute, Irk,
Bully, Vex,
Disquiet, Grate,
Beset, Bother,
Tease, Nettle,
Tantalize or
Ruffle the animals.
Sign near entrance of San Diego Zoo

June 26, 2012 -   Practicing physicians are not zoo animals.  But sometimes they feel  caged mammals   as they spend up to 1/3 of their time abiding by, complying with, being threatened by federal regulations , begging for permission to perform tests,  and taking the blame for raising costs of health by ordering “unnecessary” tests and procedure to fend off possible future malpractice suits. 
Meanwhile physician incomes, dictated in large part by a coding system devised and guided by the federal government and the AMA, has kept their income flat for over a decade while expenses have been rising 4%to 5% each year.
In survey after survey, doctors complain of “harassment” and “hassle” by third parties, parmamout among these Medicare, as they struggle to maintain their practices,  lifestyles, and sanity. 
Small wonder, then, that 2/3rds of physicians believe Obamacare will lower quality of care, decrease their autonomy, reduce their incomes, and make the practice of medicine less attractive. 
Small wonder that 25, 000 new physician are entering practice each year while 35,000 are leaving the profession. 

Small wonder that a political access crisis to physicians looms in three to 5 years, as 30 millon more Medicaid patients enter the government rolls in 2014, and 10,000 baby boomers became Medicare eligible  each day for the next 18 years.
Doctors’ reaction and resistance to Obamacare, of course, is only one factor in the politics of health reform, and it is seldom mentioned as the Supreme Court announces its decision on the constitutionality of Obamacare in two days on June 28, but I submit it is an important consideration, for it is physicians who must deliver the care under the provisions of Obamacare.
Health reform is a complicated and difficult proposition to implement in the US for many reasons beyond the scope of this blog.
But in a previous post, in September 2009.  I touched on some the reasons why. 
You might enjoy rereading this post, which I reprint now.
December 23, 2009
Government Care-Why Reform is Difficult: It's the U.S. Form of Government
In today’s The Health Care Blog, Humphrey Taylor, Chairman of the Harris Poll and Harris Interactive, speculates why U.S. health reform is more difficult than in other countries.

He gives these reasons. The comments are mine.

ONE, their systems are much simpler, i.e., they don’t have a thousand points of payment. Comment: In America, we call this freedom and choice.

TWO, they already have universal coverage and can focus on improving care, efficiency, and cost containment. Comment: In other words, government rules and trumps private sector.

THREE, they have parliamentary systems, where a simple majority rules. Comment: “Simple majorities” can lead to social tyranny.

FOUR, lobbies, i.e. special interests, are more influential in the U.S. Comment: The biggest “special interest” of them all is a dominant unchecked politic party.

FIVE, the power of money: in other countries elected officials do not have to raise vast amounts of money to be elected. Comment: I agree. A prime example is Barack Obama, who raised unprecedented amounts of money from Wall Street and Internet followers.

SIX, they only need a bare majority of votes in their legislature and have no such thing as a filibuster. Comment: Good point. Our founding fathers set up a system to frustrate sweeping changes by a “bare” majority.

SEVEN, the U.S. has partisan news networks, especially Fox News, and talk radio that spread emotional, often misleading arguments that fuel populist feelings, and dumb down the debate. Comment: This is typical elitist rhetoric, that somehow those in D.C. and liberal media have a stranglehold on intellect, wisdom, and objectivity.
Tweet:   Health reform is difficult in the U.S because of our constitution, our distrust of government, and our desire for clinical freedom.

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