According to Physicians for a National Health Program, the number of medical bankruptcies increased approximately 2,200 percent between 1981 and 2001, and of those people, nearly 76 percent had insurance at the onset of the bankrupting illness. Physicians for a National Health Program estimates that this accounted for about half of all bankruptcies in the United States in that time.
This isn’t a small problem, either. Between 1.85 million and 2.22 million Americans had to file for bankruptcy because of medical expenses in that same time period.
The Declaration of Independence states that every person has the right to life, liberty and the pursuit of happiness. The right to life shouldn’t come at the price of bankruptcy or serious financial burden. It is endowed to us by our creator, not sold to us by health care providers.
There are a lot of valid objections to the Affordable Care Act in its present form, including how the program’s financial issues will work out, but universal care needs to happen in the United States without harming doctors.
Sixty percent of doctors believe health care reform will negatively affect patient care, while only 22 percent think there will be a positive impact, according to market research done by The Doctors Co. While the Affordable Care Act is bad for doctors, there is someone else who suffers: the patient.
A projection by the Association of American Medical Colleges shows that by the year 2020, the United States will have a shortage of 91,500 doctors, predominantly because of the effects of the Affordable Care Act.
With the addition of more preventative care coverage, the new influx of patients will cause more doctors to defer the workload to nurses and nurse practitioners. While this is necessary for many small practices, it decreases the quality of care, as a patient’s time with the doctor will be more limited than it already is. The good ol’ in-and-out routine of your family practitioner will only be exaggerated. This is an unfortunate scenario since, ideally, doctors choose their profession so that they can help people and give them top-notch care.
Beginning Jan. 1, the new regulations will provide uncertainty when it comes to having a stable practice, which require all health care providers to convert every handwritten record to be logged electronically. While this is obviously ideal in the vast technological sphere we live in, getting to the end goal is not so simple. Each practitioner has hundreds, sometimes thousands, of patients. For small practices, with limited manpower and large practices with thousands of files, the cost of the manpower, training and software cannot be foreseen.
While the government originally offered incentives for making the switch in a timely fashion, a multitude of doctors chose to save the money and simply walk away from their practices altogether. Now the goodwill gestures have been thrown to the wind and penalties have been put into place for those who are noncompliant. The government will hit healthcare providers with a 1 percent decrease in all Medicare payouts if the electronic system is not fully implemented and demonstrated to be put to meaningful use by 2015.
The electronic-only system will improve care coordination in the long run, but the question begs to be asked: What about those people that the Affordable Care Act is geared toward, the elderly and those living under the poverty line? Many of these people either don’t have the means or the skill set to access a computer and the Internet.
Practitioners are not the only health care providers taking a hit by the Affordable Care Act. Hospitals are being affected as well. The new health care law allows the government to withhold Medicare payments if a patient returns to the hospital too many times after the initial treatment or procedure. So, instead of just calling in to check on their post-operative patients, doctors may have to assign nurses to make sure that patients actually fill their prescriptions and make follow-up appointments with their primary care physician. While it is important that patients are offered the best care possible and that the government is trying to promote and reward better, more efficient medical care, this handholding is a little extreme. The costs associated with such monitoring could potentially outweigh the actual Medicare payout, which is only 56 percent of what private insurance pays, according to Dr. Robert Moffit, director of the Center for Health Policy Studies at The Heritage Foundation.
The pressure to reduce cost, increase volume and improve quality is forcing many health care providers to re-evaluate their game plan. A number of doctors have chosen to go into larger, consolidated practices to stay afloat, while others, 42.9 percent to be exact, have chosen to retire in the next five years, according to research done by The Doctors Co. Nine out of 10 health care practitioners, even though some are third and fourth generation doctors, say they are unwilling to recommend health care as a profession, even to their own kids.
For those doctors who have chosen to hold onto their practices, the costs they have incurred in order to continue being effective in providing quality medical care are putting their practices in jeopardy. As individual small business costs continue to rise, the amount of money to be paid through the Affordable Care Act for the exact same services they have been providing is dropping dramatically. Unfortunately, this means there will have to be compromises in quality to be able to continue to provide some services. For instance, the 2.3 percent excise tax on all medical devices, which was implemented as a part of the Affordable Care Act in 2013, has had a negative impact on the industry. To try and avoid these additional high costs being passed on to the insured, doctors are being forced to consider layoffs and other costs reductions within their practices to make up the difference and stay afloat.
Overall, health care reform should take us back to the traditional doctor-patient relationship while still providing care to everyone. The Affordable Care Act needs to be amended to make sure this happens.
