What Does the Health Care Bill Mean for Doctors?

Commonly known as “ObamaCare,” the United States is about to undergo a major health care overhaul in the coming 2012. Officially known as the Patient Protection and Affordable Care Act (PPACA), the majority of this legislation was given almost a two year implementation period, but we are now nearing the point where its implementation is inevitable. The most controversial aspect of this legislation is a provision that requires all Americans to have health insurance. This was viewed as a necessity by health insurance companies who claim that they need a full network to cover for the costs associated with accepting people with preexisting conditions and other aspects of PPACA. As such, most of the changes associated with ObamaCare have been directed from patient or insurer perspective.But those are not the only people who will be affected. PPACA will force some changes upon the actual caregivers, the doctors who are entrusted with patient care. Most of changes will directly affect financial issues, and then possibly care indirectly. Who can pay, what they pay, how they pay, and what will result from that pay are the primary areas of change – but they could have broad effects for doctors that will be felt at the patient level.The biggest issue may lie with Medicaid and Medicare. These entitlement programs (for better or for worse) offer the current backbone for providing medical care for the poor and elderly without relying on doctors to put forth reliable care out of the goodness of their hearts. Going forward, the rates the government run programs are intended to be far less than they have been in the past. Doctors could see their revenue from Medicaid/Medicare patients cut by nearly 20% compared to what they have been accustomed to receiving. The unintended result may be that many doctors will just refuse to take these patients, limiting their options and possibly their case levels as a result. This could also trickle down to medication availability and surgery wait lists as well.For doctors who will continue to treat Medicaid and Medicare patients, they may find a greatly increased demand due to other doctors dropping those patients. This could potentially result in these doctors rationing their care and having to go to greater lengths to prioritize the patients in their queue. After RomneyCare (which served as Obama’s initial model) was implemented in Massachusetts, many patients complained of long lines and less access to the physicians of their choice. These patients claimed that getting referrals to specialists became especially difficult. Some polls even show that a significant percentage of doctors are considering dropping out of the industry altogether. Although that last point seems like an idle threat as a the medical career will still offer lucrative benefits and post-recessionary America is not exactly teeming with opportunities elsewhere.All this said, proponents of ObamaCare would argue that change to the current system was coming regardless. The sustainability of a single industry that is gobbling up a greater percentage of the US gross domestic product at an exponential rate is simply not sustainable. On that issue, they are likely right. Change was coming regardless. As a society, we will just need to understand the tradeoffs and unintended consequences that come along with the changes that we choose to implement.