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Doctors, Patients, and Obamacare
Ask your physician about how Obamacare can damage your health-services.

By Marc Siegel


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My patients have trusted me from the beginning to inform them about the new health-reform law. Such conversations are taking place in doctors offices across the country. Patients everywhere are finding out that their doctors are not happy. And patients know that if we are having trouble, it will impact the care that they receive.

Now that the health-reform law is under attack from many sides, there is a growing opportunity for doctors and patients to have their protests heard. As a practicing primary-care physician, I say Obamacare is facing a perfect storm.

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First, there is an ongoing court battle to determine the law’s constitutionality. This legal challenge, now at the federal appellate court level, is sure to reach the Supreme Court of the United States, the question being when, not if. The Obama administration is clearly in no rush to see this happen, because if the court rules against them, it will have a major impact on the 2012 election. By 2014, most of the features of the bill, including the individual mandate, will be instituted, the Independent Medicare Advisory Board will be in place, and millions more patients will be signing up for Medicaid or receiving subsidies for individual private policies or paying penalties. Once our health-care delivery system is significantly altered by these provisions, it will be much harder to repeal or remove them.

In terms of the individual mandate, Obamacare’s biggest deception remains the euphemistic use of the term “health care” in place of “insurance.” For Obamacare is not only unconstitutional in compelling a patient to buy a product, it is also suspect from a public-health perspective since having insurance does not guarantee access to health care. The inability of universal health insurance in Massachusetts to stem the flow of ER visits because of a shortage of both specialists and primary-care doctors directly debunks this myth.

If the federal government believes it must ensure health care for all as a public protection, much as a mandatory vaccine protects the public from an emerging disease, then the government must do so by providing the doctors, nurses, and clinics to deliver this care. Doctors have long understood that health insurance of all kinds interferes with — rather than promotes or enables — the practice of medicine.

Obamacare in its current form will also have catastrophic economic consequences. A new McKinsey report indicates that at least a third of businesses will cut their employee health benefits as the so-called Affordable Care Act takes hold. The number expands to 50 percent for those business owners who are most familiar with the bill. There are several reasons for this. Premiums are soaring and many businesses would rather pay the penalty than shoulder these costs at a time when the economy is still struggling. The draft regulations that accompany the new law mandate the kind of low deductible, low co-pay insurance that leads to higher premiums than businesses can afford. It would have been much smarter to move toward a higher deductible insurance in the workplace that encourages people to pay out of pocket for non-essential services or to utilize tax-friendly, flexible-spending, and health-savings accounts; but Obamacare is rendering these lower premium insurances obsolete.

Technology will inevitably be imperiled by an insurance system that covers every cough and sniffle and is over-expanded to cover the 30 million plus people who lack it. As costs skyrocket, federal bureaucrats will tighten their belts, and committees and boards like IPAB will restrict services. The problem with this approach is that it not only compromises quality of care, it also hamstrings doctors who believe that medicine is an art, where different treatment choices work for different patients. This is becoming more and more apparent at a time when our most effective — and expensive — new treatments are targeted therapies that respond to genetic abnormalities. Since everyone’s genetic signature is different, approaching illness and treatment from this perspective defies the one-size-fits-all insurance model that Obamacare perpetuates.

Doctors will flee, not only because of shrinking reimbursements amid the ever present worry of frivolous malpractice suits, but because our options for treatment will become so restricted that we will no longer be able to practice effectively.

You will get to keep your doctor, provided that he doesn’t restrict his practice or retire. In the meantime, I would suggest you ask him what he thinks about Obamacare.

— Marc Siegel, M.D., is an associate professor of medicine at NYU and the medical director of Doctor Radio at NYU Langone Medical Center. He is a Fox News medical contributor and the author of The Inner Pulse: Unlocking the Secret Code of Sickness and Health.

editors note: This article has been amended since its initial publication.

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COMMENTS   9

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   06/14/11 10:37

ObamaCare is why we are no longer members of the AMA.
I fear much of the damage has been done already with it's passing, as adjustments to practicing are already being made to comply. It is this preparation to comply and the expenses incurred that will make it's repeal not practical.
The judiciary not ordering a stay for implementation when striking down the law was a fatal move, allowing the SCOTUS to delay in it's review of the case.

Healthcare as we knew it is gone, and I don't mean in a good way covering just the waste and abuses. The CARE is being eliminated and reinstating it could prove insurmountable.

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   06/14/11 10:38

I lived under the NHS in England and it was and still is a total disaster. Long waiting lists for minor operations and treatments, long wait times just to see a primary care doctor, grossly over worked doctors and nurses because of staff shortages and death panels. The one thing that still eats at me to this day was how the NHS stole the chance for my uncle to fight for his life. He died of cancer back in the 90s but his treatment was delayed nearly six months after diagnosis due to a lack of hospital resources......by the time they got around to treating him it was already too late. I love the health system here in the states and never once thought I would see the awful NHS reappear on this side of the Atlantic. Yes this system has its problems but America has to wake up and vote this fool out of office next year before not only the greatest healthcare system is destroyed but also a great country

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Fletch F. Fletch
   06/16/11 00:10

Paddyflan:

your remark about health care in the UK takes me back many years. Question the source if you will, but I remember seeing an episode of the "Benny Hill Show" that contrasted health care at a public v. private hospital. The private hospital patients enjoyed Cadillac services, while the nationalized / "public option" hospitals make any V.A. hospital scandal in the U.S. look enviable by comparison. Young as I was at the time, I was able to discern the message loud and clear: the nationalized health care was a travesty. Little (if anything) I have seen in the intervening decades has suggested otherwise. Let us pray that Obamacare is overturned quickly and finally.

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pbjammin
   06/14/11 13:26

What would an ideal healthcare system look like if we had the ability to create it so it would include all people? I hear a lot of complaining, but no effort at a solution.

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   06/14/11 18:10

If you have neither heard nor read of any alternative ideas to fix the healthcare delivery system in America then you have not listened nor looked hard enough. Try entering the following phrase into your favorite search engine on your magic internet machine: "alternative conservative healthcare solutions"

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   06/14/11 15:58

If you want to see brain dead proposals from doctors see the advocacy pages for AMA, AAFP, ACP.

If you want to see real solutions see AAPS, Heritage, Cato, AAPP.

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Russ Davis
   06/14/11 16:12

"Doctors have long understood that health insurance of all kinds interferes with — rather than promotes or enables — the practice of medicine."
It's regrettable that those who foolishly promote insurance fail to see the universal application of this fact.

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   06/15/11 02:43

Economics, not the courts or the Congress, will prove the undoing of Obamacare. Obamacare is going to be massively expensive. The government cannot keep up with its present obligations, let alone take on new ones. I look for the Federal Government to collapse and the entire welfare state to disappear within just the next few years.

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Richard Davis
   06/15/11 09:04

The author is right that the best system involves higher deductibles and HSA. It also needs to have limits on malpractice suit amounts. Obamacare is set to ruin our system as we know it. It appears as though the fines associated with not having or providing HC insurance amount to a new form of revenue for government. Collect the fines and deny coverage. Totally wrong.

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