WASHINGTON, May 23, 2012 -- In The Secretary Shall: How the Implementation of the Affordable Care Act Will Affect Doctors, Hudson Institute Senior Fellow Tevi Troy evaluates the potentially hazardous impact that the Affordable Care Act (ACA) will have on a critical actor in American health care—the physician.
As the political and legal worlds debate the virtues and viability of the ACA and the nation follows along in confusion, America's doctors must prepare for the potentially large and deleterious impact that the new law may have on their careers, incomes, and relationships with their patients. A survey by the Doctors Company indicates that 60 percent of physicians feel that the health care law will have a negative influence on overall patient care and 51 percent feel that the law will negatively impact their relationships with patients. In light of this troubling reality, Tevi Troy, a former Deputy Secretary of the Department of Health and Human Services, examines the 2,700 page law to explain why these concerns may be well-founded.
The cost of the Obama health care law will put additional strains on our health care system. This cost, coupled with the Medicare cuts that will pay for part of the bill, will in turn make it harder for Congress to come up with the funds to pay for the "doc fix," Congress' annual effort to stave off mandated cuts to doctor reimbursements. In addition, the Affordable Care Act will also limit decision-making authority by doctors via the creation of the Independent Payment Advisory Board. This shift of control, joined with new red tape and the reduced reimbursement rates, could force doctors to reconsider the structure of their practices. Some will opt for cash-only boutique practices, while others will be compelled to abandon their individual practices and join larger groups that are better equipped to handle insurers and new regulations. Troy posits an even more worrisome outcome of the new law in which more doctors will elect to forsake the practice of medicine, and talented young people will be discouraged from entering the field. Given the physician shortage that this country already faces, these outcomes would have frightening repercussions.
Finally, Troy argues that an enhanced regulatory burden and constrained autonomy will disincentivize physicians from pursuing important technological and medical innovations that might lead to new and currently unanticipated cures.
As Troy makes clear, for America's doctors, and their patients, the $800+ billion cost of the Affordable Care Act is a mere fraction of the total cost, both financial and social, that the new law may impose.