A Physician's Response to the State of the Union Address
The foundation of excellent medical care is the power to choose your doctor and, in partnership with that doctor, decide your course of treatment. With the Affordable Care Act, the government has inserted itself to become the final arbiter of your care. It will ultimately decide who becomes the health winners and losers.
Proponents of Obamacare want people to believe that the system is so broken that it can only be fixed through fundamental change. The disastrous rollout has certainly fed the push for a single-payer system, but an argument can be made that the government bailout written into the bill has actually already ushered in single-payer--since whoever controls the money also controls the access and makes the rules.
As the Obamacare train wreck continues to roll out, it will become painfully obvious to patients that although they have health insurance with no pre-existing conditions restrictions, free birth control, and preventative care, for several reasons they still may not be able to afford access to medical care when they need it: the out-of-pocket costs from their co-insurance and deductibles are so high; they will find that because they qualified for a subsidy, they will have that money clawed back the following year if their financial situation improves; and if they took the Medicaid option, they will be unable to leave any of their wealth to loved ones because the government will take it to recoup payments made for their health care.
Physicians will ultimately discover that they have no control of their talents. They will be considered providers of services that are rights that must be given--for whatever value the government deems fair. They will become interchangeable with the healthcare team, and with that innovation, individualized health care and the art of medicine will be gone forever.
But the antidote to what is ailing the American healthcare system is NOT more government intervention; it is more choice via free market medicine.