Government run health insurance programs often reimburse physicians at rates that are less than the actual cost of treatment and as a result, some physicians are choosing to opt-out of the system. Today, 13% of all physicians no longer accept Medicare and nearly 33% refuse to participate in the Medicaid program.
Ayn Rand wrote about State controlled healthcare in her 1957 novel, Atlas Shrugged:
“I quit when medicine was placed under State control, some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything—except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards—never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”
Obamacare was designed to provide universal healthcare coverage, but with one critical oversight; the focus has been almost entirely on the patient, with little or no consideration given to those providing the care.
The United States already faces a growing physician shortage. Can we expect it to get worse?
Effective January 1, 2015, a provision of Obamacare goes into effect that will tie physician payments to patient outcome. Physicians will see their payments modified so that those who provide “higher value care” will receive higher payments while those who provide “lower quality care” will receive lower payments.
Ask yourself, should you ever become extremely sick, what doctor would want to risk their “higher value care” payment to treat you?
Deadly Indifference: The Perfect (Political) Storm: Hurricane Katrina, the Bush White House, and Beyond by Michael D. Brown
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