In 2013, the American people learned what whoppers the key promises of ObamaCare turned out to be. But the biggest whopper about the Affordable Care Act is yet to be exposed: the tightening grip the federal government will have over your doctor — even if you’re paying with private insurance.
Like so many other parts of ObamaCare, the reality flies in the face of promises. In this case, it was the one where the president assured us that “you’re not going to have anybody getting in between you and your doctor in your decision making.”
Section 1311(h)(1)(B) of the health law gives the secretary of Health and Human Services blanket authority to dictate how doctors treat patients. Not just patients in government programs like Medicare and Medicaid, but patients with private plans they pay for themselves. On Dec. 2, 2013, we learned from the Federal Register that the rules are now being written. Starting in 2015, insurance companies will be barred from doing business with doctors who fail to comply. The rules will be offered in the name of ensuring “health-care quality,” which of course could mean anything.
“The powers given to the secretary are so broad, he or she could literally dictate how all physicians nationwide practice medicine,” warns Congressman Phil Gingrey (R. Georgia), himself a physician. Gingrey is sponsoring a bill to repeal Section 1311(h)(1)(B). Otherwise, he says, the HHS secretary — a Washington bureaucrat with no medical training — could, for example, bar doctors from doing routine mammogram screenings until female patients turn 50. In short, the federal government will be calling the shots on what patients get.
The rules have not been announced, but we have some hints from the president’s key health advisor when the Affordable Care Act was written, Dr. Ezekiel Emanuel. Early on, he suggested that doctors take the Hippocratic Oath too seriously “as an imperative to do everything for the patient regardless of the cost or effects on others.”
His point was that so long as doctors are in charge, cost control would not be possible. “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely lipstick cost control,” he said, “more for show and public relations than true change.” In contrast, ObamaCare empowers the HHS secretary to limit care by imposing top-down regulations directly on doctors and hospitals.
Obama’s nominee to run the Centers for Medicare and Medicaid Services (CMS), Dr. Donald Berwick, also insisted the federal government must step in between doctors and their patients to curb and redistribute the use of medical resources. Berwick said resources should be allocated based on “important subgroups.” These groups, rather than the individual patient in the doctor’s office, he said, should be the “unit of concern.”
In other words, these considerations are more important than what your doctor decides for you. So if you want to get the treatment your doctor suggests, you’d better hope you’re in the right demographic.
Right now states license and discipline doctors. And that’s plenty of oversight. In 2006, when the US attorney general tried to interfere in how Oregon doctors used controlled substances to treat patients, the US Supreme Court struck down the federal intrusion. In Oregon v. Gonzalez, the high court warned it would amount to a “radical shift of authority from the states to the federal government to define general standards of medical practice in every locality.”
Yet this is precisely what ObamaCare does. It puts the federal government between you and your doctor with an eye toward limiting your care. And in the coming months, millions of Americans are going to learn that the president’s assurances to the contrary rank right up there with “if you like your plan, you can keep it.”
Betsy McCaughey is a former Lt. Governor of New York and author of Beating Obamacare 2014 (available starting in January, 2014).