Last week, politicians who helped craft the Affordable Care Act (ACA) celebrated in self-congratulatory style the third anniversary of that monstrosity which will soon extinguish health care as we’ve known it.
The president’s promises about the ACA saving money and allowing you to keep your existing health plan are proving false, as many predicted.
The Department of Health and Human Services maintains the law will make health care more affordable and accessible. The Wall Street Journal, reminding readers of that claim, reported last week that health insurers are privately warning brokers: “premiums for many individuals and small businesses could increase sharply next year.”
The 2013 Deloitte Survey of U.S. Physicians, a survey of more than 600 physicians from the Deloitte Center for Health Solutions, found that “Six in 10 physicians (62 percent) said it is likely many of their colleagues will retire earlier than planned in the next one to three years.”
Based on the survey results, Deloitte found that most U.S. physicians believe that, among other worries, under Obamacare, “The future of the medical profession may be in jeopardy as it loses clinical autonomy and compensation” and “Medicaid and Medicare reimbursements may be problematic, prompting many physicians to limit or close their practices to these enrollees.” Instead of the established doctor-patient relationship of old, “eight in 10 physicians agree “that the wave of the future in medicine ... involves interdisciplinary teams and care coordinators.”
One who thinks he’s seen the future and doesn’t like it, is my physician, Dr. John Curry of Fairfax, Va. At my request, he sent me the following email:
“Forty years ago, when I began practicing primary care medicine, medical decision-making and its funding were in the hands of patients and their physicians. The only protection patients had lay in the professional ethics of their doctors. In modern terms that sounds pretty skimpy, but think about it for a minute. The first precept was ‘Do no harm’. Ask yourself: can you hold your government to that standard?
“The underlying principle was that the physician had to put his patients’ interests ahead of his own. This was, of course, the Golden Rule, formalized into standards for professional care. It was also the reason I, and many in my class, applied to medical school. It was the reason my wife’s older brother, who practiced medicine in a small town in West Texas, prided himself on the fact that much of the time he ‘was paid in peas and pies.’ Again, ask yourself, is there any health insurance company or government agency that you can count upon to put your health above their interests?
“The decades have rolled by, and the sea-changes have come. Costs have risen, and personalized care has faded. The monstrosity has been birthed, and soon you will look in vain if you are seeking a personal physician who knows you, cares about you and to whom you have ready access. You will find only systems, ready to suck you up, give you a number and provide you with federally approved accountable care in a sterile environment populated by highly regulated strangers. And it will cost you a lot! (Whatever anyone says, prepare for a future where your health costs will be higher and your choices fewer!)
“I am in my mid-70s and have both the capacity and willingness to care for patients for another decade. But I am retiring. I cannot stand it anymore. More than half of my time in the office is spent filling out forms, writing letters, responding to inquiries and attending to ‘urgent’ matters that did not exist 10 years ago. And every year my income is less. At this point I would rather be paid nothing and have the freedom to decide what is right for my patients. ACA is only another straw, but for this tired camel, it will break my back.”
Neither I, nor the country, can afford to lose doctors like John Curry, but we are and we will. Take two aspirin, but don’t call in the morning because Dr. Curry and many like him won’t be there to answer the phone.