Obamacare hasn’t yet been fully implemented but it’s already driving up the cost of health care and killing small medical practices. At the same time, it’s helping big hospitals become even bigger.
Thomas Lewandowski, a Wisconsin heart doctor, was faced with a dilemma after his Medicare payments were cut and his overhead costs soared: Fire half his staff to keep his practice open, or sell it to a local hospital.
He decided to sell, becoming one of more than 6,000 employees at Thedacare, which runs five hospitals and numerous clinics in northeast Wisconsin. It’s a decision being made increasingly in the U.S., creating a new dynamic that threatens to raise the price of health care, even as the federal government and states strain to keep a lid on costs.
Under Medicare’s tangled payment system, hospitals get higher reimbursements than individual doctors for cardiology treatment, as they do for other specialty services, in some cases as much as three times more. At the same time, the added bargaining power gained by controlling more of the heart care in a geographic market has given large hospital systems added leverage in negotiating reimbursements from insurers, such as UnitedHealth Group Inc. (UNH) and WellPoint Inc. (WLP)
One cardiologist said the people who concocted these payments schemes need to have their heads examined. He also said his previous plan to work well into his retirement years has been scrapped.
For cardiologists, the move to hospitals has good and bad aspects, according to Lewandowski, the Wisconsin heart doctor who sold his practice in 2010. While they may gain more stable incomes, doctors often have less freedom over how they care for their patients under strict hospital protocols. Some doctors are also under pressure to see more patients each day when they are employed by a hospital, he said.
“I miss being in private practice and being my own boss,” said Alexander, the Illinois cardiologist. “I would have said 30 years ago that I planned on dying with my boots on, and practicing until I couldn’t practice anymore.
‘‘Now, do I look forward to retirement?’’ he asked. ‘‘Yes. Do I plan on working forever? No.’’
Timothy Carney notes how this is part of the trend of big government helping big businesses while putting smaller competitors out of business.
This is standard. Dodd-Frank looks like it is making big banks bigger. Toy-safety regulation has accrued to the benefit of the big toymakers while killing Mom n Pop competitors. Wal-Mart’s support for theemployer mandate in health insurance and a higher minimum wage weren’t philanthropy. There’s a reason Philip Morris supported FDA regulation of tobacco and smaller cigarette companies called it the “Marlboro Monopoly Act.”
Looks like Obamacare is going down the same path — and undermining its stated purpose of lower costs. Of course, this never was a cost-control bill in the first place. (Read More)
Doctors retiring early will result in fewer of them as patients are being herded into these massive hospitals (filled with germs) for treatment. Gee, what could possibly go wrong?