Monday, July 2, 2012

Is There a Doctor in the House? ('Gone Galt'?)

On July 1st, William Bigelow at published an article on a survey of doctors' reactions to the PPACA. As many as 83% of those surveyed are considering closing their offices and "Going Galt". 39% of  those surveyed see the healthcare industry and the services provided declining drastically over the next five years.

PJ Media published an article covering a video captured by Ari Armstrong at an Anti-Obamacare rally in Colorado hosted by Americans For Prosperity. In that video, Dr. Jill Vecchio describes how the law will force physicians to practice substandard medicine and violate their Hippocratic oaths.

The Patient Protection and Affordable Care Act (deemed a tax law by the US Supreme Court) does little to actually protect patients. It also makes healthcare more costly to 60% of adult US citizens through increased taxes and fees. The hard truth found in the first, second, and third order effects of this law is that it will make healthcare less accessible to people in the long run.

Some of the provisions, already in effect, are having a negative impact on healthcare availability and the providers' ability to service their patients. One medical administrator stated the impact she has already encountered in her workplace.

First, the sluggish economy and provisions of the bill forced her doctor and his medical cooperative to sell to the largest for-profit healthcare conglomerate in Massachusetts. This forced cost increases to those patients with private health insurance, Healthcare Savings Accounts, or paying out of pocket; undoing what little good "Romneycare" had done in the first place.

Next, the impact upon the salaries and benefits of the workers (including the doctor, who is now an employee) reduced. That gives less an incentive to actually work. In addition, the number of allowable sick days, Paid-Time-Off (PTO), and personal days decreased for these workers, which can add to burnout (therefore chance of more mistakes).

Another key impact is the increase in red-tape now involved in seeing the doctor. Those who may qualify for or are receiving any form of government subsidy for healthcare have paperwork to complete. The forms required have more than doubled in length, requiring as long as 45 minutes to complete. And these forms must be completed each visit. So, what would have been a simple hour-long visit to a doctor's office just doubled. That is if the patient doesn't require assistance from the administrators in filling out the paperwork. Already overloaded with an increased workload of administrative paperwork, those administrators need to make time to help those patients. So a patient may have to wait up to 30 additional minutes for that assistance.

One would think the simple answer would be to hire more administrators. Due to decreased wages and increased overhead, many doctors simply cannot afford to hire them. The workload has doubled, but the ability to hire the necessary personnel is impeded. To hire that additional administrator the doctors would have to fire a nurse, technician, or physician's assistant. That would mean more administrators and fewer healthcare providers.

Then you have the mandated limits on treatment such as those that Dr. Vecchio discussed. The administrator spoke of similar limits imposed upon her doctor already. These limits mean limits on services provided by technicians such as phlebotomy technicians, X-ray technicians, sonogram technicians, medical laboratory personnel, and physical therapists.

The PPACA also contains salary caps for healthcare professionals set to go into effect over the next 3 years. Combined with the increased overhead, limits to care allowed to provide, and imposed violations to the Hippocratic Oath, doctors are looking to retire early or simply will not be able to afford to practice.

One surgeon called into Neal Boortz's syndicated radio show broadcast out of WSB in Atlanta, GA. This surgeon and his wife, also a surgeon, have decided to move  to New Zealand. They have bought land and already received their visas, according to the caller.

A cardiologist, age 53, stated his intent to retire within the next year. He simply cannot afford to keep his practice. The administrators, nurses, and technicians he employs are scrambling to find other employment, which appears not readily available.

One X-ray technician, in Texas, was shocked at the possibilities before her. She now sees her new career is in jeopardy. What first appeared to be a stable long-term career is now looking unstable. After reading sections of the 2800+ page PPACA, she now worries if she'll have a job next year or the year after as more provisions are implemented.

Increasing the administrative bureaucracy while decreasing the availability of actual healthcare providers will make the medical services provided by the Veterans' Administration look streamlined and efficient compared to what will be provided by the once private industry.