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First wave of Obamacare destroys single practice doctors

Obamacare's destructive provisions have already begun.
Obamacare's destructive provisions have already begun.
Photo by Joe Raedle

Perhaps nothing is any more deeply embedded into the American experience and the collective unconscious than the single-practice family doctor. But now, due to the provisions of Obamacare, or the so-called Affordable Care Act, the single-practice doctor is quickly becoming obsolete.

A three-page report at U-T San Diego indicates that Obamacare is destroying single practice doctors. These physicians are being driven out of medicine directly due to unreasonable records requirements and lower reimbursement rates from the Medicare and Medicaid programs, all of which are mandated by the Affordable Care Act.

The fact that Obamacare is dealing a death blow to doctors should come as no surprise to anyone. Conservatives and rational-minded moderates have screamed from the beginning that one of the ways the program will destroy the American system of healthcare is by driving doctors out of medicine. The American people were warned. Yet they sent many of the very same politicians who support medical practice homicide right back into office. Obama was reelected as well.

In 2009 I was invited to be one of the speakers at a doctors' tea party gathering in Raleigh, N.C. The physicians who spoke painted a doomsday scenario in which America would would plummet to the equivalent of a third-world healthcare system. They stated that no competent physician could operate under the conditions and terms mandated by Obamacare and that most of them would either leave medicine altogether, or if they were old enough, retire early.

Their statements were not exaggerations. The very thing that the doctors predicted at that park in Raleigh in 2009 is happening right before our eyes.

The report published in U-T San Diego delineates the reasons the Affordable Care Act is dealing the death blow to single practice physicians. First, Obamacare mandates high priced treatment and billing record software while forcing the doctors to accept a third less in fees for procedures. Skyrocketing costs to do business, together with a sharp decline in payment rates, means that many single doctor practices cannot afford to stay in business.

America has reached this crisis gradually, dating back specifically to the Clinton Administration in the early 1990s. Ever since that time doctors have been forced to accept much lower payments for Medicare and Medicaid care so that government can keep the growing costs of healthcare under control.

But Obamacare appears to be the straw that broke the camel's back, accelerating the pace of the demise. The U-T San Diego report states,

For many doctors, it’s the final straw. Surveys suggest that older physicians are retiring in high numbers. Younger ones are closing practices and taking jobs with integrated health systems.

Early this month, I spent a few hours with my friends Dr. Doug Moir, a heart specialist in Escondido, and his wife, Margaret, who runs the business side of their one-doc practice (which also includes a nurse and assistant).

Both Moirs are pillars of the Escondido community. Just thinking about their volunteer schedule wears me out.

Over a 40-year career, Doug has helped thousands of people, both inside and outside his practice. At a robust 72, he’d love to keep going, but he increasingly questions how long he can afford it.

“This year we’re looking at putting money into the business to keep it going,” he said.

Federal data backs up Margaret’s account of revenue pressure.

But many younger physicians do not have the means to pump their own personal funds into keeping their practices afloat. These doctors are closing up shop and joining large clinics where they get lost in a sea of personnel and where patients are treated as numbers rather than human beings.

The eventual result is clear. Severe doctor shortages. Your friendly small town doctor who knows your family, your history, and your medical needs will be a thing of the past, especially in rural areas and small towns. Patients will be forced to drive long distances to large medical centers just to see a doctor who doesn't know them from Adam.

And the worse part of it is that the top large medical practices and hospitals in the nation have opted out of participating in Obamacare, period. Want to go to the world-renowned Cleveland Clinic? Sorry, but no luck. They want nothing to do with Obamacare. The same thing goes for the Mayo Clinic, Cedars Sinai, and others.

But this is socialism, you see. Socialism never strives for excellence but the lowest common denominator. Thus, rather than finding a way for the poorest among us to participate in the excellence that has been the hallmark of the American healthcare system for decades, you lower the standards for everybody so that the few can at least get a blood pressure check. And in the process you destroy the very healthcare system that has produced excellence all of these years.

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