What is REALLY wrong with the VA/ ACA

The main concern for the future of US healthcare is neither socialized medicine (VA), single payer (Canada) or government funded insurance (ACA); other countries have applied variants of these models with various degrees of success. 

The big problem facing the healthcare of the United States is that both political parties are forcibly applying flawed tools and methodology towards 21^st century medicine::

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Obamacare is more than an insurance program, its regulations accelerate the computerization and industrialization of all medicine. It is a fundamental change in the patient-doctor relationship, instead of being your advocate, your health care provider (nurse, doctor, physician assistant, allied health professional), becomes a servant of government and corporate regulators.  Non-compliance by your HCP (health care provider)  with federal mandates can mean large financial penalties and loss of their licensure.

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            A computer is a tool, like all tools, the computer has a proper application and usage.  Although excellent for banking, real estate and social networking, computer usage mandated by the ACA (affordable care act)  does not strengthen the doctor-patient relationship.  Since their introduction computers have neither improved the quality, nor reduced the cost of medicine.¹   

…                                                                                                                                         Computerized or electronic medical records reduce your information security and privacy.   Computerized records are much easier to steal in bulk than a room full of paper charts. James Van Dyke, president of Javelin Strategy & Research; “prediction is that as medical providers increase their use of electronic medical records, the incidents of fraud will increase.²”

 

            Computerization of medicine also means that your HCP spends large amounts of time with administrative duties such as completing paper work or electronic medical records.  In 2012, twenty-two percent of a physician’s time was spent on non-clinical duties, resulting in a loss of over 6 million hours of potential patient care.³   In multiple surveys, more than 70% of doctors reported that too much regulation/paper work was a major reason for dissatisfaction with medicine as a profession. ^{3, 4}

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            Industrialization of medicine means that doctors no longer work in independently owned private practices.  Increasingly HCPs will work for a large company that dictates their method and style of patient care.  As a member of a corporation or federal bureaucracy, your HCP is often placed in an undesirable situation, choosing between your health care needs and the economic demands of employers, regulators and/or insurers. ^{3, 4}

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      Regulation and industrialization mandated by the ACA has caused both loss of independence and payment for private practice physicians. Medicare payments for procedures (ECHO, MRI, etc.) are often two to three times greater if performed in a corporate or hospital setting rather than your independent physician’s office.  Continued implementation of the ACA causes less private practice medicine and less lucrative employment for allied healthcare professionals. Similar to the consolidation of the airlines and cable television, what follows for consumers is less choice, less access and higher costs.

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      Private physician offices represent a very large part of the Texas economy. Although an economic impact study for Texas is not available, Florida did a detailed study in 2009 that revealed each private physician’s office on average employed 19 people and generated $913,000 in personal income.⁵  In Florida, a state 25% smaller  in population than Texas, their private physician offices generated $55.7 billion in economic activity in 2009, which is more than all their hotels, motels, casinos and amusement parks (including Disney) combined!

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     Although you may empathize with your HCP- doctors and nurses are intelligent, motivated and capable people; they will adapt. Fear for your family, less private practice physicians means less care for the elderly, disabled and severely ill.       Even with declining payments, common methods by which burned out (40 - 60%) doctors and nurses are coping with the unrealistic demands of the ACA are retiring early, quitting private practice, taking less call and refusing new Medicaid and Medicare patients. ^{3, 4}

Also “Physicians are working fewer hours on average and seeing fewer patients than 4 years ago. If these patterns continue, over 44,250 full-time-equivalent physicians could be lost from the workforce in the next four years.³”

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1  Lucas Mearian, Computer World Dec 2009

2  Information Week, March 26, 2010

3  The Physicians Foundation by Merritt Hawkins,

    survey of  13,575 practicing physicians, Sep. 2012.   

4  Practical Neurology, survey of TX MDs, Sep  2013

5  Florida Med Assoc., Economic Impact Study, 2009

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http://www.nationaljournal.com/health-care/doctor-shortages-aren-t-just-a-veterans-affairs-problem-they-re-a-nationwide-problem-20140602…