I am sitting here in my white lab coat with dirty sleeves (from use), thinking that there is no reason for a practicing physician to support the current health reforms before Congress. Patients are going to have a rude awakening when their new insurance cards don't give them the kind of access to doctors they are expecting. Doctors are too frustrated and marginalized to play ball with the president. Here are the reasons that every doctor I know is vehemently against Obamacare_
* No comprehensive tort reform. Most surgeons I know are struggling with a constant fear of malpractice claims. Most have had at least two or three frivolous lawsuits in their careers to contend with. Most have spent hundreds of hours with lawyers going over the fine print of their records only to have the case settled. Most surgeons are now opting out of accepting insurances in order to afford their malpractice premiums which are often close to $100,000 yearly. Caps on pain and suffering are only one part of the problem. 32 states have some kind of tort reform already, but there needs to be a consistant federal mandate or doctors will hop from state to state. In California, when caps of $250,000 were instituted, doctors' premiums did not decrease until a second law compelled insurers to transfer savings to physicians. Nuisance suits can be blocked by creating boards of doctors and lawyers to review cases before they are brought (these boards already exist in Tennessee and Michigan). "Loser pays" statutes can be added (doctors win the vast majority of suits) so that liability insurance companies won't force doctors to prematurely settle claims to avoid large legal fees. * The bills before Congress all include large Medicare cuts. The Baucus bill would cut Medicare by $500 billion over a decade. This will lead to cuts to hospitals who will then be compelled to cut patient services and doctor salaries. The moratorium for not cutting doctor reimbursements across the board by 21% as Congress is supposed to do is not likely to last. Medicare cuts to doctors will cause more to quit or game the system. A changeover from fee-for-service to bundled payments, as the Baucus bill envisions, will leave many doctors out in the cold when they are denied payment for a service that is considered unnecessary or redundant. * The growing doctor shortage - the Association of American Medical Colleges calculates we will be 125,000 doctors short by 2025 - does not leave us with the manpower to take care of an additional 30 to 40 million patients. Doctors will be more rushed than ever. * The extension of Medicaid to 10 million more people as the Baucus bill proposes will be a disaster for doctors. Consider that Medicaid often pays doctors less than $10 per office visit. 50% of doctors don't take Medicaid, and states have already been cutting Medicaid payments to hospitals because most states are having trouble funding Medicaid. Medicaid networks of services and service providers within hospitals are being cut, making it impossible for doctors like me to take care of these patients (we have nowhere to send them for services or procedures).
We doctors are being squeezed, marginalized, ignored, and criticized. Of course we aren't happy. Of course we feel that it will impact our patients' care.
If there is a hardworking doctor out there who thinks the current health reforms are good for doctors or America, I don't know her.
Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel's new Ebook: Swine Flu; the New Pandemic, will be published in early October. Dr. Siegel is also the author of "False Alarm: The Truth About the Epidemic of Fear"and "Bird Flu: Everything You Need to Know About the Next Pandemic."Read more at www.doctorsiegel.com