Next Obamacare Battle's Gonna Hurt (video and picture)

Fewer and fewer doctors in the U.S. are self-employed, and more are employed by hospitals. That is a direct result of government policy, sharply accelerated by Obamacare. The trend will be damaging to American healthcare. It is still possible to reverse the decline, but powerful forces want it to continue.

A Foolish And Dangerous Paranoia

Doctors effectively can’t own new hospitals any more. That’s because the Big Hospital lobby convinced the leftists who designed Obamacare that physicians owning hospitals was a conflict of interest. That’s right: according to that theory, the people who have devoted their lives to the study of medicine want to own hospitals so they can profit by withholding care, or by overcharging for it.

The trouble with that line of reasoning is that the non-physicians in charge of hospitals and insurance companies have no such conflict. Their incentives are to provide as little care as possible while charging as much as they can. Their desire to protect their personal reputations and adherence to ethical code are not as strong as for physicians.

If you could invent the kind of person to run a healthcare business, you would invent a physician.

To reverse this, repeal Obamacare.

The Costs

While half of all physicians currently work for independent practices, three of four doctors hired this year will go to work for hospitals, according to one study.

As Dr. Scott Gottlieb wrote last year, hospitals are on a buying binge:

“Doctor practices are being acquired at a rapid clip. While some physicians are choosing to sell their practices to integrated delivery systems that are provider led, the majority of doctors are selling their practices to hospitals.

“This should have everyone concerned. For one thing, there’s ample evidence that provider productivity declines when doctors become salaried employees of hospitals. (Some selected research, analysis, and commentary of these trends can be found here: A, B, C, D, E, F, G, H)”

In less urban areas, the hospital and high school can be the largest employers. That leads state and local governments to give them preferential treatment to preserve the jobs associated with them.

Dr. Jason Fodeman of the Galen Institute lays out the question: Will doctors working for hospitals lead to lower costs, or higher?

“The Medicare Payment Advisory Commission (MedPAC) says that the trend toward hospital-employed doctors may drive up costs because care that was once billed as physician visits will be billed at higher hospital outpatient rates — even when they occur in the same location. In addition, many hospitals charge facility fees for visits with doctors in their system.” MOREHERE