EXECUTIVE SUMMARY
While much has been said about the
Patient Protection and Affordable Care Act (PPACA), lengthy debates have
failed to adequately address the impact that the 2,800 pages will have
on doctors, patients, and the practice of medicine. This Galen Institute
white paper does just that. This paper examines in detail how the
government already hinders physicians’ abilities to provide good care
for their patients and how these harmful trends will only worsen under
PPACA.
Medicare’s physician reimbursement regimen is fraught with
underpayments and perverse incentives. During the health care debate,
supporters of PPACA praised Medicare’s ability to exploit its size to
obtain lower fees with providers. While it is true that Medicare can
bludgeon down physician fees, this is not one of the program’s greatest
strengths, but actually one of its greatest weaknesses. These
underpayments are ultimately shifted to patients in the form of shorter
visits, less doctor face time, quick hospital discharges, and
compromised care. Rather than reforming the government’s flawed
reimbursement regimen, PPACA merely expands its scope to more people.
Health
care is currently one of the most regulated industries in the country.
Doctors already devote a significant amount of their day to detailed
documentation, paperwork, and signatures. This takes away from potential
time doctors can spend at the bedside with their patients. These
requirements are likely to increase under the health overhaul law. New
regulations will place unaccountable bureaucrats in Washington, D.C.,
between physicians and patients and grant these regulators unprecedented
control over medical decisions. While this will no doubt be frustrating
for doctors, it will be the patient facing limited access and choice.
PPACA
will strip away physician autonomy, drown doctors in bureaucracy, and
drain job satisfaction. As the profession deteriorates, older doctors
will retire while younger doctors will look to switch careers. Many
students considering a careering in medicine will pursue other
opportunities. The supply of providers will dwindle as demand for
services reaches an all-time high. Ultimately, the consequences of
health overhaul law will be passed along to patients through restricted
access, long wait for appointments, and rationed care.
The Patient Protection and Affordable Care Act is indeed bad for doctors, but it is always the patient that suffers the most.
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