Unintended Consequences of PPACA – Say Farewell To Three Decades of Managed Care

Source: The Business of Medical Practice; Transformational Health 2.0 Skills For Doctors by David Marchiko & Hope Hetico

(1) Health care costs will be shifted to doctors in the form of lower reimbursments, (2) Hospital based physicians will demand and receive higher salaries, (3) Fewer physicians and more nurse practicioners, (4) Higher health insurance costs, (5) Medical care access impediments for most Americans but improvements for those previously uninsured, (6) Increased acceptance of MSA’s, HSA’s, concierge medicine, private pay, and other direct cash payment methods for medical care (7) widespread health data breach of epic proportions, (8) more community hospitals will close, (9) Fewer alternatives to commercial health insurance, other than Medicare and Medicaid, since the antitrust exemption for health insurers had not been repealed, (10) Medicare may become the de facto health insurance, much like public housing, food stamps, the USPS, and public transportation, (11) Physician compensation will gradually decline, (12) Private medical practices, often a doctor’s largest financial asset, will go down in value jeopardizing personal retirement plans, (13) Medicine’s lost professional status will become complete as health care becomes commoditized.

“…..health insurance reform is setting the stage for a new era of American health care. In launching this new period anchored by expanded access and insurance market reforms, we are expecting to say farewell to the three-decade era of Managed Care – a barren stretch of fiscal and social desert marked by spiraling costs, misaligned financial incentives, massive underfunding of Medicare and Medicaid obligations, fraud, overtreatment, public to private cost shifting, historic rates of chronic illness, and the slow erosion of employer sponsored health care, leading to an astounding number of Americans without insurance. …”

According to the author, whereas the old era was “a time characterized by consolidation of stakeholders, cost shifting, risk shifting, and scorched earth Darwinian battles on the supply and delivery side”, the new era will” begin a battle for the soul of medicine.”

Editor’s Note: This book is a must read for health insurance consultants