As I was watching CNN news recently, I noted in the headlines different ways Obamacare is failing. Current problems discussed were the customers’ sticker shock of high deductible plans (up to $12,700 for families), the president blaming the insurance companies for having substandard plans, and the people blaming the president for losing their current insurance.
One patient even complained, “My new health care plan tripled in price, and now, it is like having a third loan to deal with, including my car and home loan.”
The current law and regulations being implemented under Obamacare will ultimately lead to sicker patients and low quality care for three reasons:
1. Older doctors will retire early fed up with the system. These older doctors feel that the loss of a patient-physician relationship and the burdensome regulations (ie. paperwork) will choke off their ability to provide good care. In addition, their expenses are increasing with these new regulations. Add in the projected cuts in reimbursement up to 26%, and their livelihood will be threatened. These cuts could force these doctors out of practice or force them to stop seeing Medicare patients simply because their expenses (which rise yearly) are exceeding their declining reimbursement, which has declined steadily over the past several years already.
2. Young smart minds will no longer enter the field. This is due to rising debt (average $250,000 after medical school) and severe cuts in reimbursement (yearly threats of 26% cuts to reimbursement). If young college students realize that they cannot provide for a family despite going to school and training for 14 years, deferring income for all those years, and then being slapped with a $250,000 medical school bill, they will turn to different professions.
3. Current younger doctors will become more demoralized by administration and lawmakers dictating how they provide care. They will feel as if they are increasingly being treated as machines, expecting to provide great care such as answering patient calls at 2am, working 24 hours shifts, doing more procedures for less, and filling out more and more paperwork, all with the threat of getting sued if they don’t perform without making a mistake. This will produce a high burnout rate and poorer care.
These doctors went into medicine to feel a healthy bond between themselves and their patients. They enjoy talking and spending time with them in the office. Unfortunately, with all the unnecessary documentation regulations and time restraints, doctors are losing the bond that is so critical for care. For those doctors who choose to stay in the field of medicine, many of them will instead elect to practice concierge medicine, taking the insurance company out of the equation and attempting to maintain the physician-patient relationship.
There are numerous articles out there that show concierge medicine is growing. With current doctors feeling demoralized and younger students afraid to enter the field, this will create a massive shortage of doctors and threaten the health of our citizens.
Having said all this, I as a doctor do not want this to happen. I went into medicine as a calling to help others and take this role seriously. I longed for the idea of sitting down and talking with my patients, sharing stories with them, not on the clock, and without cumbersome, slow computers and administrators documenting every move I make. I want every person in America to have access to quality health care all at a reasonable price because our citizens deserve this.
Unfortunately, universal access to care at a reasonable price cannot materialize unless lawmakers look to doctors on the front lines of care for specific input. We as doctors know in many ways why costs are high and why the public is unfortunately misinformed about how it all works. But we need a representative sample of practicing doctors in Congress discussing these issues so that these “insider” insights can be applied to our current laws.
-Matthew Moeller is a practicing Gastroenterologist. He can be reached on twitter (@DrMMoeller).