Obamacare: Policy Changes - The Good, the Bad, the Ugly

By now you’ve likely heard the the Supreme Court has upheld the constitutionality of Patient Protection and Affordable Care Act, also known as Obamacare.

What was interesting about the ruling, however, is that it was upheld as a tax, as opposed to a penalty or fee, which means Barack Obama is now the creator of the largest tax assessed against the American people.

One thing you may want to note, however, is that finance bills (including tax bills) must originate in the House (according to our Constitution), not in the Senate.

Obamacare was originated in the Senate. What will become of the bill on that aspect? Some suggest the bill is nullified, while others insist it doesn’t matter as it’s been upheld already.

So how will Obamacare affect you and your practice? The overwhelming majority say the outlook looks bleak. Doctor Patient Medical Association Foundation conducted a survey of random doctors in May 2012.

The survey was faxed, and here are some interesting results.

• Almost unanimous that medicine is on the wrong track, and overwhelmingly blame the government;
• Highest numbers ever opting out of Medicare or refuse Medicaid;
• Vacuum in leadership in medical profession, feel abandoned by AMA & organized medicine;
• Corporate medicine (including hospital and insurance companies) is intentionally trying to destroy private practice;
• Doctors are pessimistic – failing financially & assume things will worsen.

Do you Agree or Disagree with Obamacare?

If you don’t like the law and you want to fight the law, you can do so by writing your Representative in the House and your Senator. The House has scheduled a repeal vote for July 11th- with hopes of overturning the law. Although this is mostly symbolic in nature, since the it must then be repealed in the Senate, and with 51 Democrats, 47 Republicans, and 2 Independents, having a simple majority vote (and changing any of the Democrats’ minds) is highly unlikely.

If that fails, none the less, there is one more option, which is to vote Republican (Mitt Romney) on November 6th. Mitt Romney has vowed to repeal the law on his first day in office, and says he’ll implement policies to allow the states to make their own choices regarding the healthcare matter.

I for one do not get involved with Politics, I believe whoever the best candidate at the time regardless of party should win. Now I do like the fact that Obama is actually trying to change everything that has been broken for many years. It takes courage, and I think the American people respect him for actually making a difference.

Obamacare Vs. Romney

More than likely you’ve heard the idea that Obamacare was based on Romney’s version in Massachusetts. Massachusetts does indeed, include a mandate provision, requiring citizens to take on the responsibility of their own health costs. But there are several key differences that will show the difference between a large, Federal undertaking, where Obama envisions a Single Payer System in the future, and Romney’s state solution.

The first most notably is the size of the bill itself. The Federal law is 2700 pages, to govern and micro manage many aspects of doctors, health insurance, medical panels, etc while Romney’s bill was just 70 pages. Obama’s bill takes on more costs in the form of subsidies. In the Federal law, subsidies are provided for those citizens earning up to 400 percent of the federal poverty level whereas in the Massachusetts bills, they are provided for just up to 300 percent.

In addition, subsidies are denied to those who have coverage through their work, where as the Federal law allows subsidies to be given to workers in their premium contributions are above a certain amount.

The Federal Law (active as of 2013) requires “bundling” where doctors, hospital, and other providers are paid per care episode and the payment is divided up among providers, instead of the current system where each provider is paid for their individual service. As of 2015, the bill seeks to pay providers based on quality of care and not on quantity of patients, which may seem like a good idea at first, until you realize that it’s the government deciding what is quality, and not the patient sitting in your office.

Summary of Obamacare

In short, the Federal law seeks to dictate healthcare in all realms thereby taking much of the control out of the hands of doctors and patients. And as we see from other forms of government run healthcare, like Medicaid and Medicare, doctor reimbursements will be low- meaning you take in less while having higher costs. End result, you get paid less while doing a less effective job in a shorter amount of time. Patients have less time with you and therefore are less satisfied.

If you’d like to read the healthcare law in full, head over here.