HSIEH: The Coming Collectivization of American Health Care

The Accountable Care Organization is yet another Orwellian-named idea that is an assault on freedom and common sense.

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The Wolf Files

VERBATIM POST
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Under this new system, the traditional 2-4 person small group medical practices many Americans are familiar with would rapidly become an endangered species. ObamaCare legislation requires doctors who accept Medicare patients to follow strict new documentation standards as well as to purchase (and make “meaningful use” of) government-approved electronic medical record systems. These requirements can impose enormous financial and administrative burdens on small medical offices. Coupled with declining reimbursements, many small practices will thus have an increasingly difficult time staying afloat.

Hence, many doctors are already choosing to merge into larger practices (or become hospital employees) to remain economically viable. In 2010, the Medical Group Management Association reported that 65% of established physicians hired and 49% of new physicians finishing residency chose to join hospital-based practices. Similarly, the American Medical Association reported that from 2001 to 2008, the number of physicians in solo practice fell from 37% to 25% and in small 2-4 person practices fell from 26% to 21%, with these numbers expected to decline even further.

The ACO is a thinly-veiled attempt to get control of doctors. The end result will be the ultimate two-tiered system that liberals say they abhor. Doctors who can, will quit doing business with the government altogether (i.e., drop out of Medicare, Medicaid, etc.) and take only those patients who can afford to pay them without government involvement (and perhaps even without private insurance involvement). What's that? You can't afford to shell out ten grand for an unexpected surgery? No problem, take a number and go get in the government line. Meanwhile the wealthy will avoid that second-class system.

What's worse, even the groups that served as models for the ACO concept say they won't participate in them.

The Administration wrote its rule based on an ACO pilot program that started in 2005 among 10 high-performing physician groups, including Geisinger Health System and Dartmouth-Hitchcock. All 10 say they have "serious reservations" about the new rule and that without major revisions "we will be unable to participate." In other words, the providers that are already closest to being an ACO have rejected the Administration's handiwork.

The Soviets, as Paul Hsieh describes, thought they could collectivize farmers under strict government rules. The result? Despite having some of the most abundant and fertile farm land in the world, the collectivized nation soon couldn't even feed itself.