Critical Condition

NRO’s health-care blog.

The New Defensive Medicine


Scott Gottlieb has a must-read piece in today’s WSJ about behavioral shifts among insurers and doctors in reaction to President Obama’s health-care plan.

According to Gottlieb, “[i]n 2005, doctors owned more than two-thirds of all medical practices. By next year, more than 60% of physicians will be salaried employees.” He attributes this shift to a combination of insurers pushing for lower provider costs, reductions in Medicare reimbursements, the burden of mandated electronic-medical-record purchasing, and increasing medical malpractice costs in states that have not adopted tort reform. The combination of these policies and incentives by the Obama administration is creating a new type of “defensive medicine,” in which doctors eschew individual or small group practices in order to gain the protection of large and powerful hospital or insurance patrons. 



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