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Is This the Beginning of Real Healthcare Reform?
Published Online: Thursday, January 20th, 2011

As I write this, we are barely 24 hours removed from the U.S. House of Representatives voting overwhelmingly to repeal Obamacare (the final tally was 245-189, with three Democrats breaking party ranks).

Representative John Sullivan (R., Okla.) explained his reasons for voting for repeal and summed up the case against the President Obama’s healthcare reform law when he told the Tulsa World, “Obamacare is bad for patients, bad for doctors, bad for small business and terrible for our stagnant economy… Small-business owners across my district are scared to death that the president's healthcare law is putting them out of business.”

Dan Boren (D., Okla.) said that the current law “adds far too many taxes, mandates and regulations” that burden families and “prevent job creators from producing sorely needed economic growth.” This economics-based case against Obamacare has been widely reported in the news and resonated with millions of voters who are concerned for their jobs in this fragile economy.

Healthcare coverage that will end up destroying hundreds of thousands of jobs -- and plunge the country deeper into debt -- doesn’t sound like a good deal to a majority of Americans, who responded by sending their Representatives to Washington with a mandate to repeal the law. Many hope it is replaced with common-sense reforms that preserve the people’s right to have a choice in their healthcare, actually control costs without jeopardizing job growth, and keep the focus of healthcare on the patient-physician relationship.

Right around the same time that the House was taking the first step on the path to repeal and reform, we received further confirmation that Obamacare is particularly hurtful for the small businesses that are the heart and soul of healthcare: physician practices. HCPlexus and Thomson Reuters recently announced the results of the 2011 National Physicians Survey, which asked nearly 3,000 primary-care physicians and specialists their opinions about a variety of subjects, including “the quality of health care in the near future in light of the Patient Protection and Affordable Care Act (PPACA)” and “the specific consequences both physicians and patients may encounter” because of PPACA.

According to the executive summary of the 2011 National Physicians Survey, which carries the apt subtitle “Frustration and Dismay in a Time of Change,” 65% of American physicians are worried that healthcare quality will deteriorate in the next five years unless major changes are made. Nearly three out of four physicians (74%) think that along with this drop in quality, “the PPACA will result in less-fair physician reimbursement.”

One respondent summarized the case thusly: Obamacare “will have a negative impact because the 30 million newly insured will not be able to find a primary-care physician. There is already a shortage, and nobody is interested in primary-care anymore. There is too much uncompensated work, and it keeps increasing. ERs will be even more impacted than they are now, due to lack of access to primary care. The very presence of these patients will negatively impact the care of other ER patients. It is unlikely the reimbursement for care of these millions of souls will be very good, so physicians with already full practices will have no interest in taking on any of them.”

Declining quality of care, brought on in large part by “reform” that is designed to place more of a burden on already overworked and overwhelmed physicians, requiring them to try to do more with less (time, money, and autonomy) while assuming an ever-greater share of the financial risk of providing care? It’s no wonder that so many physicians and patients finally said enough is enough. Their Representatives heard that message loud and clear. The whole country is watching to see whether this vote was merely a symbolic gesture or the first step toward real, common-sense reform.

Thank you for reading.

Mike Hennessy
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KdH
Ok, all these are good points. But what is the alternative? The law gives the uninsured the right to show up at the hospital's door step, and they do. Are we realistically looking at the hidden cost to the system they incur, and do we care what care (or lack thereof) those among us who cannot afford insurance receive?

PS: I wouldn't worry too much about what physicians worry about in polls, they are professional worriers, but usually don't see far past their own horizons.
January 27, 2011 - [ 18:49:54 ]
MV
KdH - What is the alternative? You are at least as shortsighted, if not more, than others since you can not even fathom an alternative. Simple, include true TORT reform, not the handwaving nonsense that Obama and other supporters of PPACA either espoused or ignored. There is not a single study or opinion by anyone or any group that suggests that TORT reform will not have ANY impact. Also, PPACA really and primarily reforms healthcare care costs and does so by regulation. Change, thinking that any change always brings positive effects is not rational. Also, since the US is the ONLY country with health insurance delivery the way it is and not even looking at much less trying to use the systems of other SUCCESSFUL countries as a template is like reinventing the wheel.
January 30, 2011 - [ 9:29:52 ]
KdH
MV, thanks for your answer. I actually probably feel pretty much the way you do, just did not make myself clear. My frustration is with those who seem to feel that leaving the uninsured to their own devices does not cost us anything. I do have alternative ideas and also know that there are a number of good models elsewhere that could probably be adapted to work here. (I went to medical school in Germany, so my horizon is not that limited.)
KdH
January 30, 2011 - [ 18:11:38 ]
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October 18, 2011 - [ 10:24:41 ]
Mike Hennessy
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Hennessy's Highlights dissects the healthcare policy issues that impact physicians, particularly those who are running their own practices.
Author Bio
Mike Hennessy is Chairman and CEO of MJH & Associates, the publisher of many influential journals, including The American Journal of Managed Care, Pharmacy Times, MDNG, Politics, Oncology & Biotechnology News, and Physician's Money Digest. As a businessman, entrepreneur, and a publisher of magazines and websites that focus on the financial and professional needs of physicians, Hennessy is intimately familiar with the challenges physicians face in today's competitive practice environment.
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