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Tuesday, May 25, 2010

How the new healthcare law can cause you to lose your physician

The partisan healthcare "reform" train has left the station, and patients may soon be realizing their physicians aren't on board. Medicare and Medicaid patients are already feeling the painful impact of the government's squeeze of physicians, and the prognosis for other patients is not good.

My friend Bob Moffit at the Heritage Foundation writes of the impact of Obamacare on physicians:
No class of American professionals will be more negatively impacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act than physicians. Third-party payment arrangements already compromise the independence and integrity of the medical profession; Obamacare  will reinforce the worst of these features.

Physician payments in the major entitlement programs, Medicare  and Medicaid, are already well below the prevailing rates in the private sector. On average, physicians in Medicare are paid 81 percent of private payment; physicians in Medicaid are paid 56 percent of private payment.[2]  Medicare payment has resulted in sporadic access problems for Medicare patients, and the lower Medicaid payments have already contributed to serious access problems for low-income persons and worsened hospital emergency room overcrowding. In a recent survey conducted by Opinion Research Corporation, 67 percent of primary care physicians said that under current conditions new Medicaid enrollees would not be able to find a “suitable primary care physician” in their area.
It's not hard to figure out where this trend will leave patients--searching in vain to find a physician who participates in Medicare and Medicaid. And if slashed physician payments are not enough to nudge physicians out of medicine, the new healthcare law piles on layers of bureacracies that interfere in the patient-physician relationship and further emasculate physicians' decision-making ability. Bob offers three examples:
1.  Under section 6301, Obamacare creates a “non-profit” Patient-Centered Outcomes Research Institute. It will be financed through a trust fund, with initial funding starting at $10 million this year and reaching $150 million annually in fiscal year 2013, with additional revenues from insurance fees. In effect, the institute will be examining clinical effectiveness of medical treatments, procedures, drugs, and medical devices. Much will depend upon how the findings and recommendations will be implemented and any financial incentives, penalties, or regulatory requirements.
2. Under section 3403, there will be an Independent Payment Advisory Board in 2012, with 15 members appointed by the President and confirmed by the Senate. The board would aim to reduce the per capita growth rate in Medicare spending in accordance with specified targets (based initially on measures of inflation and eventually GDP growth) and make recommendations for slowing growth in non-federal health programs. The board’s recommendations would go into effect unless Congress enacts an alternative proposal. An unprecedented cap on Medicare spending, the process would doubtless reduce Medicare physician payment.
3. Under section 3002, the law extends the Physician Quality Reporting Initiative. While it provides incentives for the quality of care delivered to Medicare beneficiaries, the program is nonetheless burdened with time-consuming compliance and reporting requirements.
What does all this mean to physicians?
Athena Health conducts scientific surveys to determine what physicians think. One of their latest polls, the Physician Sentiment Index, indicates the following troubling indicators:
  • 64% of physicians believe that healthcare decisions are based more on what the payer wants than what is best for the patient. (To feel this impact, imagine you're a cancer patient and the physician prescribes the most effective drug only to be vetoed by the government bureaucracy or insurance company.)

  • 92% of physicians are already frustrated with insurance paperwork. (If you've ever spent a frustrating afternoon at the Dept. of Motor Vehicles, imagine doing that every day and you get the drift.)

  • 54% say more government involvement in health care will not help.
  • Only 17% are optimistic about the capability of American physicians to practice independently or in small groups in the future.
What would you do if your job paid less and less, required more and more bureaucratic paperwork, took away your decision-making authority and kept you from helping the people you entered that career to help? Only the most dedicated physicians will persevere in such a climate.
Among those are faith-based physicians, many of whom care for the poor and marginalized. Yet because the same faith that motivates these physicians to care for the poor also motivates them to uphold the sanctity of human life, conscience protections are essential to their continued practice of medicine.
Tragically, the Obama administration has announced plans to get rid of the only federal regulation protecting faith-based physicians from getting forced out of medicine for following moral standards and their consciences. Abortion partisans in Congress blocked attempts to include strong conscience protections in the partisan healthcare law.
So with tens of millions of new patients now slated to be added to the healthcare system under the new law ... with an already acute shortage of primary care physicians ... and with faith-based physicians facing expulsion from medicine for following their consciences, isn't it time to stop this runaway healthcare "reform" train?
After November, a new Congress will have a chance to repeal the healthcare debacle and in its place enact sensible, bipartisan reform that will not only benefit patients but also the physicians who serve them. Vote as if keeping your trusted physician depends on it--because it does.

Wednesday, May 12, 2010

Washington Post reveals conscience rights gaps in healthcare law

The Washington Post recently ran a surprisingly balanced report on conscience rights,"New health-care law raises concerns about respecting providers' consciences." I had worked with Post reporter Rob Stein as he researched the various perspectives and technical questions about conscience provisions in the new healthcare law. I congratulate Rob on focusing on the key issues and presenting a reasonably balanced summary. Here are a few excerpts:
Deep within the massive health-care overhaul legislation, a few little-noticed provisions have quietly reignited one of the bitterest debates in medicine: how to balance the right of doctors, nurses and other workers to refuse to provide services on moral or religious grounds with the right of patients to get care.
...But some argue that the legislation does not go nearly far enough, given the breadth of the new legislation and possible unanticipated effects. For example, the legislation does not protect workers who oppose abortion from discrimination by any entities other than health plans, leaving federal, state and local governments, clinics, hospitals and others potentially free to compel providers to perform abortions, they say.
"At the end of the day regarding the legislation, a pro-life health-care professional is left with a weak and limited conscience provision that doesn't even prohibit discrimination by governments and institutions," said Jonathan Imbody, vice president for government relations at the Christian Medical Association.
And the legislation does not safeguard doctors, nurses and others who object to anything else, especially care that might be mandated by the federal government as "essential services," such as birth control pills, sterilization, genetic testing and in-vitro fertilization. Read the full article
As with other aspects of the new healthcare law, many Americans are just now realizing how dangerous it is and will be. That's why some Members of Congress whom I've talked with in closed-door meetings are advocating a one-step repeal-and-reform strategy to undo the damage and enact truly healthy healthcare reform.
What to do? Find out where your Congressional candidates stand on healthcare law repeal and reform, and vote accordingly.

Monday, May 3, 2010

Jack the Quack is Back

Chicago Sun-Times TV Critic Paige Wiser observes of convicted murderer Jack Kevorkian, portrayed by Al Pacino in HBO's recently released movie, "You don't know Jack," that there is "something off-putting about the man."
That's putting it mildly.
Jack Kevorkian is a death-obsessed quack who lost his medical license and demonstrated why—because he didn't discern the difference between healing patients, which he never did during his deadly campaign, and killing and assisting in the suicides of patients, which he did with reckless abandon.
Jack Kevorkian advocated for the suicides of terminally ill patients, but his medical ineptness and blind ideology led to the deaths of five victims who weren't even sick. It would have been better for these victims to have had Al Pacino acting as their doctor.
The Hippocratic oath was adopted over two millennia ago to protect patients by establishing boundaries that bind the physician to heal and never to harm. Apart from a physician's adherence to the Hippocratic oath ("I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan"), patients can't know whether their doctor will heal them or kill them. “Dr. Death” Jack Kevorkian represents an over two thousand-year regression in medical ethics.
Kevorkian's suicidal and homicidal actions demonstrates that quacks don't know jack about protecting patients.