Why Physicians Oppose the Insurance Mandate
Jan 9, 2012
By: Author-Contributor, AAPS President, Alieta Eck, MD,
There is much confusion about the health insurance mandate in ObamaCare. Its advocates assume that deadbeats will avoid buying insurance until they get sick, thus gaming the system, and causing the premiums to rise for everyone else. However, since insurance will be forced to cover pre-existing conditions without charging more, the law will actually encourage this behavior.
The most important reason to oppose the mandate is that the government gets to choose what we are mandated to buy. This leaves room for all types of “providers” to lobby Congress to have their particular service included in the mandate. The government also determines allowable deductibles, administrative costs, and covered services—and who is allowed to provide those services. All this will raise premiums, reduce the number of available insurance products, and reduce choice for American patients.
To insure that everyone complies and buys insurance, the IRS will be hiring 17,000 new workers, paid for by the ever shrinking pool of taxpayers. And when people protest that they cannot afford the high-priced insurance, ObamaCare has come up with the “compassionate” answer of declaring that those who earn 133% of the “poverty” level will be eligible for Medicaid. This means they get to pay nothing for their “insurance” but the taxpayers are stuck with the bill. A healthy family of four will provide a $20,000 windfall for the Medicaid HMO. Odds are, these families will need very little medical care in a given year—but if they do, they’ll have trouble finding it because Medicaid payments to physicians are so low that few can afford to take it. Meanwhile CEO compensation for Medicaid HMOs is notoriously high.
Let’s look at the effect of a specific mandate, mammograms. Current recommendations suggest that every woman over 40 ought to get one yearly. Thus insurance companies are mandated to pay for mammograms with no charge to the patient. The reasoning goes that catching breast cancer early is a good thing and will save money overall. It is also assumed that providing the service for free will remove the major barrier to access.
But what will this really cost? Radiology groups will have to do the mammogram, billers will code and bill the insurance company, the insurance company will process the claim, verifying that the patient has paid her monthly premium, and cut a check to the radiologist—anywhere from one to three months later. It is estimated that the administrative costs for such a claim amount to about $50.
Multiply $50 by, say, 50 million women over 40. That is $2.5 billion in administrative costs—for a service that can now be obtained for as little as $80 cash. The administrative burden will nearly double the cost for this one service with no proof that the quality or access to care will be any better than it is today.
On top of the cost, physicians will be now given the task of prodding each woman to get her mammogram, with his own compensation being lowered if she does not. Cost is not the only deterrent women have to getting screening mammograms, others being discomfort, fear, or simple procrastination. Yet the doctor will be expected to hire personnel to track compliance in his ever enlarging nanny role.
ObamaCare needs to be labeled what it is—an expensive, burdensome, private sector job-killing bureaucratic nightmare that will ultimately bankrupt the states and extend the economic recession.
We do not need Big Government to tell us what to do, but liberty to act in our own best interest. Instead of buying expensive government-approved insurance, we need the option to buy the insurance we want with the deductible and the coverage we want. We need to freedom to establish a relationship with a physician who is a trusted coach and confidant, paying him directly for most services.
Physicians are tired of government meddling, as if we do not know how to care for patients. We love our profession and love to see and help patients get well. We do not love the exploding paperwork burden and the constant intrusion of the government inserting its will between our patients and us.
Dr. Alieta Eck, MD, President of AAPS graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988. She has been involved in health care reform since residency and is convinced that the government is a poor provider of medical care. She testified before the Joint Economic Committee of the US Congress in 2004 about better ways to deliver health care in the United States. In 2003, she and her husband founded the Zarephath Health Center, a free clinic for the poor and uninsured that currently cares for 300-400 patients per month utilizing the donated services of volunteer physicians and nurses. Dr. Eck is a long time member of the Christian Medical Dental Association and in 2009 joined the board of the Association of American Physicians and Surgeons. In addition, she serves on the board of Christian Care Medi-Share, a faith based medical cost sharing Ministry. She is a member of Zarephath Christian Church and she and her husband have five children, one in medical school in NJ.