Physicians reacted with shock and anger to the Supreme Court’s decision to uphold the President Obama’s health care law, according to poll data and the leaders of activist groups, which are continuing to fight the law in court and via political action.
According to Kathryn Serkes, cofounder of the Doctor Patient Medical Association, a recent nationwide poll sponsored by her organization found 83 percent of U.S. physicians have considered leaving their practices due to President Obama’s law.
“This not just something that started today, and it’s not something that just started with passage” of Obama’s law, said Serkes. “There have been developments in medicine that have made it very, very difficult and have put some seriously different pressures on doctors. But this bill has certainly brought things to a head.”
Doctors Fight Back
John Richardson, executive director of the Physician Hospitals of America, sent a letter to Congress on July 11 detailing PHA’s opposition to Obama’s law.
The letter notes the law “unilaterally banned any new hospitals owned by or in partnership with physicians from seeing Medicare and Medicaid patients.”
“The American Hospital Association has been advocating for years to put physician ownership out of business, and so it’s no secret who has been lobbying Congress for years to get that through,” Richardson said. “In fact, they had amendments on ten different bills over the five years leading up to the 2010 PPACA, in which time they tried to attach similar language. They’re not supposed to pick a winner and a loser, but that’s what happened.”
Jonathan Ingram, senior health care analyst with the Illinois Policy Institute, says doctors are pushing back against government regulations.
“The government says the new restrictions are to prohibit physicians with ownership stakes in hospitals from cherry-picking patients, referring higher-paying patients to the hospitals they own and sending the lower-paying patients to community hospitals,” said Ingram.
However, the result of these restrictions “is fewer choices for consumers and less competition among hospitals. It’s just one more case of big government picking winners and losers,” Ingram explained.
A federal lawsuit challenging the constitutionality of these new restrictions is currently before the Fifth U.S. Circuit Court of Appeals, Ingram said. In Physician Hospitals of America, et al. v. Sebelius, Judge Jerry Smith required the U.S. Department of Justice to state the government’s position on judicial review of laws enacted by Congress, following public statements by President Obama that appeared to call it into question.
“Anybody else in the country can own a hospital,” Richardson said. “Foreign nationals can own hospitals. Everybody else can. The only people who are not allowed to are physicians and their immediate family members. We’ve been singled out. We are the one group that take an oath that our patients come first, and we believe strongly that that’s why we do such a good job.”
Scott Oostdyk, lead counsel in the case, agrees. “It really it doesn’t make sense,” he said.
“It was without question a political payoff,” Oostdyk charged. “The American Hospital Association has been advancing the idea for years. It’s really no secret who has been behind the lobbying effort. Vice President Joe Biden, Sen. Max Baucus of Montana, and Obama Chief of Staff Rahm Emanuel were the ones most involved. In exchange for their support of the bill and its long term rate cuts, the American Hospital Association wanted to stop one of their competitors.”
Conflict of Interest on Cost
Oostdyk said the idea of physician conflict of interest was embedded in Obama’s law.
“They decided to use that nonissue as a fig leaf,” said Oostdyk, “saying there was a conflict of interest when there wasn’t. For physicians it’s all about patient outcomes. If you don’t have good outcomes, your reputation will suffer. Your name is on the door. No doctor who puts his name on the line and values the trust of his partners is going to concoct a scheme to defraud his partners and patients.”
“I see no logical reason for this,” continued Oostdyk. “It’s all part of a political agenda, not backed up by the data, not part of a rational basis for congressional action. Corporate and community-owned hospitals are very good competitors for the PHA. They needed to lessen their costs in order to soften the impact of their lessened reimbursement rates under the law.”
Doctors Facing Decision
Dr. Mark Schiller, cofounder of the Doctor Patient Medical Association, said the law puts all doctors in a position of deciding whether to continue or not.
“This is going to destroy the medical system,” Schiller said. “We know it. We know it’s going to bureaucratize medicine. It’s going decrease the quality of the care we’re providing. It’s going to make life intolerable for physicians who are going to be leaving the profession, I believe.”
Dr. Caroline Triepel, an orthopedic surgeon in Virginia, said the pressure the government has exerted gives her pause.
“This has of course profound, and just bad, ramifications on our ability to take care of patients,” said Triepel. “Patients are going to lose access. A piece of paper that says you have insurance does not translate to care, and quality is going to diminish. Doctors are going to leave, and it’s only going to add to the fiscal crisis in our country.”