Do You Want a ‘Free’ Doctor?

May 18, 2016

 
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Health care consolidation limits freedom and independence. The government’s drive to consolidate doctors and hospitals – and thereby more easily exert control -- began with Medicare and continues under Obamacare. Here’s how:
 
First, health insurers are consolidating. Medicare unconstitutionally prohibits private purchase of health insurance after age 65. Obamacare prohibits purchase of catastrophic insurance after age 29. This prohibition enabled the Obamacare scam, which gave us all expensive high-deductible plans. Even worse, hospitals and physicians are merging into Obamacare’s Accountable Care Organizations (ACOs), hospitals and clinics that together act as “insurers,” bear the financial risk of treatment and create conflicts of interest with patients.
 
Second, rural hospitals are closing. Due to declining payments under Obamacare, 48 rural hospitals have closed since 2010 and another 283 are in trouble, reports The Washington Post. This means fewer hospitals at a greater distance from patients. Obamacare cuts to Medicare and to uncompensated care are much to blame.
 
The cost of Obama’s federal electronic health record (EHR) mandate has also been difficult. Smaller hospitals have merged with larger hospitals because they couldn’t bear the cost.
 
Furthermore, all hospitals nationwide are under their second major “price control” assault. In 1983, Medicare instituted the prospective payment system, which created fixed reimbursements for care rather than payments based on hospital costs. This closed 440 small hospitals. To stop the exodus, Congress created a “critical-access hospital” designation in 1997, exempting smaller hospitals from Medicare’s “fixed payment” system. But fixed payments are back today in Obamacare’s bundled, lump-sum, and “episode of care” payments.
 
Third, Medicare payment reforms will destroy the private practice of medicine. As just one example, the $300 million in penalties for 87% of solo practices under the new  Merit-based Incentive Payment System (MIPS) are expected to cause retirements, consolidation and more employed doctors.
 
But physicians can break free. Physicians should stop participating in Medicare and Medicaid  -- it’s time to leave bureaucratic paperwork and >132,000 pages of federal regulations behind -- but be willingly to see these patients for an affordable cash-based price. Physicians should refuse to sign health plan contracts and open their doors to all patients. This will lower prices, bust up the care-restricting managed care networks and eliminate corporate control of medical decisions.
 
Insured patients should encourage their doctors to deal directly with them – and be ready to pay their non-major medical bills in cash, check or charge. Unless patients and doctors make a break for freedom together, the government’s drive to total control will put health freedom on auto-destruct.
 
For freedom’s cause,
 
Twila Brase, RN, PHN
President and Co-founder