How the government makes things worse...

Doctors And AMA Split Over Contentious Issue Of ObamaCare

For more than 160 years, the American Medical Association has served as the self-appointed chief lobbying group for doctors. But the AMA’s lofty status has been under threat over the last several years — and is under attack today. In fact, the AMA now only counts about 17% of doctors as members.

According to a new survey, the majority of doctors do not believe that the AMA represents their views and interests. Much of that dissatisfaction stems from the organization’s support for President Obama’s contentious health care reform package.

That shouldn’t be surprising. The AMA declares that its core mission is to “help doctors help patients.” But ObamaCare undermines that pursuit by making life harder for physicians and driving down the quality of care available to patients.

The survey — conducted by physician recruitment firm Jackson & Coker — is a brutal indictment of both the AMA and ObamaCare. Just 13% of doctors agree with their trade association’s support of the health reform law.

Some doctors are even dissociating themselves from the AMA. Of those who have terminated their membership, 47% cited the organization’s continued backing of the health care law as the primary reason. Increasingly doctors are turning to associations like Docs4PatientCare and the Association of American Physicians and Surgeons that actually do represent their interests.

The Jackson & Coker survey joins a large stack of research with similar findings. In February, the National Physicians Survey discovered that more than three times as many doctors believed that the quality of American health care would “deteriorate” rather than “improve” under ObamaCare. Nine of ten physicians think ObamaCare will have a negative impact on their profession.

There’s no doubt that it will.

Why? For starters, the law doesn’t address one of doctors’ most serious concerns — reimbursement rates for patients covered by Medicare and Medicaid. In fact, it stretches these programs’ shaky finances even further.

On average, physicians treating Medicare beneficiaries receive 81% of the rate private insurers pay. For Medicaid patients, reimbursements are even lower — just 56% of the private rate. In 2009, underpayments to hospitals amounted to $36.5 billion.

Cheerleaders for Medicare and Medicaid claim that the government is just driving a hard bargain. But these underpayments end up hurting both healthcare providers and patients.

Doctors pocket about $20 for each Medicaid patient they see. By contrast, an hour with a privately insured patient means payment of up to $260.

To compensate for lower government rates, doctors must increase their patient load. Every patient consequently spends less time with the doctor.

In some cases, doctors are responding to low reimbursements by refusing to see patients with public insurance. The American Academy of Family Physicians found that 13% of doctors did not partake in Medicare in 2009.

The numbers are even worse for Medicaid. The Houston Chronicle reported that doctors in Texas are leaving the program because of declining reimbursements at an “alarming” rate, with more than 300 drop-outs between 2008 and 2010. In Dallas, just 38.6% of physicians participated in 2009.

Given the paltry amount they’re reimbursed for seeing a Medicaid patient — and the cost of overhead — a doctor may actually lose money on each additional public patient he or she sees.

As the number of doctors who will treat them dwindles, beneficiaries of public insurance often must resort to costly alternatives like emergency rooms (ER) — even if they only need routine care.

More than 30% of Medicaid enrollees visited an ER in 2007, compared to the less than 20% of Americans with private insurance.

These visits exert a huge burden on the U.S. health care system. A 2009 study in the Annals of Internal Medicine found that treatment for three common illnesses cost an average of $166 at a general practitioner’s office. The very same treatment could run upwards of $570 in an ER.

Up to 27% of visits to ERs across the country are for non-emergency medical treatment. These unnecessary visits end up costing the country approximately $4.4 billion each year.

ObamaCare will only make these matters worse. By 2019, Medicaid will cover at least an additional 18 million Americans. All these new beneficiaries may have nominal insurance coverage. But they’ll struggle to secure a doctor’s appointment and will thus turn to already over-worked ER staffs.

The AMA claims that its top priority is helping doctors. Yet the organization has backed a law that would force some physicians to work longer hours for less pay and others to operate in perpetually overcrowded emergency rooms.

If doctors — those on the front lines of American health care — don’t support this massive overhaul of our medical system, then who can?

Sally C. Pipes is President, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her latest book is The Truth About Obamacare.