Friday, October 29, 2010

For Patient Autonomy: Repeal ObamaCare

Dr. Alieta Eck of AAPS, and Drs. Pegg, Hansen and Lovett of Docs4PstientCare assisted the Independant Womens Forum in making this commercial prompting voters to ask their candidates to pledge to repeal ObamaCare if elected.

Listen carefully to their message, because it gets right to the heart of the matter: ObamaCare takes control away from patients and doctors and gives it to government bureaucrats. The PPACA may be primarily insurance reform, but whoever controls insurance, controls the payment for medical care and will eventually have to control what gets paid for. That means deciding what your treatment options will be.

The solution?

Repeal ObamaCare.
Restore choice and accountability--for patients, doctors, hospitals and insurance companies.
In a free country, we all have our part to play.

Then, to make sure we don't simply go back to the problems which prompted health care reform, the next steps include:

1. End government policies which give preferential tax treatment to employer-based insurance with first-dollar coverage. Instead, all medical expenditures must have the same tax advantage or disadvantage. This will increase the availability of insurance for individuals, and insurance portability for everyone.

2. Allow insurance companies to complete across state lines. Insurance companies from states with the least intrusive regulations are already less expensive than those in heavily regulated states, so prices for insurance will rapidly drop. (For an Oct. 2010 report on health insurance mandates by state, see here.)

3. Remove legal limits and hindrances to purchasing catastrophic health care combined with a Heathcare Savings Accounts so people can more easily take advantage of this form of insurance which has repeatedly demonstrated its superiority in lowering health care spending and maintaining patient satisfaction. A significant part of the cost problem in health care relates to the perverse incentives which occur in a third-party payer system.

4. Allow balance billing for Medicare to end the massive amount of cost-shifting doctors and hospitals have to do in order to make up for the inadequate payments they receive from the government. When doctors are able see Medicare patients without losing money, the doctor shortage for Medicare patients will disappear.

5. Encourage states to enact real tort reform. Defensive medicine increases testing and procedures and drives up costs.

But first, we have to repeal ObamaCare.


Monday, October 18, 2010

ACOs Threaten Quality Medical Care

The PPACA is "nudging" doctors out of independent practice and into working as employees of large practice groups or hospitals. This move is occurring because of the bundled payment structure of Accountable Care Organizations (ACOs) which favors "vertical integration" of doctors, hospitals and health plans.

The only problem is that bundled payments are simply capitation rewritten, and employee physicians face divided loyalties between the needs of their employers and the desires/needs of their patients.

This arrangement is especially insidious when coupled with the ethics of "social justice" which gives a physician the moral OK to sacrifice his patients to the "greater good" of society. What is good medicine for the masses is often at direct odds with what is good for the individual patient--and thus, quality medical care suffers.


For more on the PPACA effects on private practices see "Killing Marcus Welby: How ObamaCare stifles private practices" by Scott Gottlieb, MD, NY Post 10/18/100

For more on problems with the underlying assumptions for ACO's see "On Being Politically Incorrect and Realistically Correct about ACOs" by Richard Reece, MD at Medinnovation, 10/7/10

For more on the destructive effects of the concept of "Social Justice" on the availability of quality medical care, see Dr. Rich Fogoros at The Covert Rationing Blog.(multiple posts)

See also:'"Deconstructing ACOs" by John Goodman at John Goodman's Health Policy Blog, 8/18/10