Doctor’s View

Michael Ramirez Cartoon

 

You shouldn’t judge the Affordable Care Act based on headlines or by listening to politicians or talking heads. I tried for a while, but only heard wildly conflicting stories that seemed to have little basis in reality.

Instead, you should ask someone who actually deals with the law on a daily basis — a doctor, for instance.

The Physicians Foundation did exactly that in its “2014 Survey of American Physicians,” which was released last month. The survey, which reached over 80% of doctors in the U.S. and elicited responses from some 20,000, is doctors’ collective report card on the Affordable Care Act’s first four years.

The grades aren’t good. Only 25% of doctors give it an “A” or a “B” grade. Nearly half ( 46%) give it a “D” or an “F”.

I can help explain why so many of us are fed up with the law: In many cases, it shifts our focus from patients to paperwork, from finding cures to filing documents.

The survey indicates that physicians now spend 20% of their time on non-clinical paperwork. I now spend many hours at a desk or a computer rather than at the bedside assisting patients. This isn’t why I became a doctor.

Unsurprisingly, this shift negatively influences patients’ access to health care — doctors simply don’t have the time to see the same number of patients.

The survey indicates that 44% of doctors “plan to take one or more steps that would reduce patient access to their services.” This includes “cutting back on patients seen, retiring, working part-time, closing their practice to new patients or seeking a non-clinical job.”

I would add another important effect based on my own observations: Spending less time with patients.

The ACA’s regulatory burden directly bears on these decisions. There are already at least 11,000 pages of government regulations related to the law. Some of it applies to insurers, some of it applies to doctors and some applies to the relationship between the two.

No matter who it applies to, it adds bureaucratic hassles to the health care process that may impact your doctors’ ability to attend to your medical needs.

It should come as no surprise, then, that 69% of physicians “believe their clinical autonomy is sometimes or often limited,” meaning they have a diminished ability to make medical decisions in consultation with patients.

And “limited” may be an understatement. The ACA’s implementation has also coincided with a dramatic decline in private practice — the small, personal doctors’ offices that have been in local communities for generations.

The number of private-practice doctors has dropped by nearly half in a mere six years, with the most dramatic drops occurring in the four years since the Affordable Care Act was signed into law.

According to the survey, 35% of physicians are now independent practice owners. In 2012, half were independent. In 2008 — two years before the ACA was passed — 62% were independent. In the last two years alone, the number of solo practitioners has dropped from 25% to 17%.

No wonder: Private and solo practitioners often lack the staff and the financial resources required to implement and keep up with the ACA’s dramatic changes to medicine.

The Physicians Foundation survey indicates that our country’s health care is still going in the wrong direction. Of course, it’s important to note that the Affordable Care Act is only one of many issues affecting doctors’ decisions and outlook.

But it is not a good sign that in the law’s first few years, physicians are seeing fewer patients, private practices are disappearing and nearly twice as many doctors believe the law is harming, not helping, American health care.

• Fodeman is an internal medicine doctor practicing in Tucson, Ariz. (IBD)

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You’ll Be Crying Over Spilled Milk

Our friends at The EPA are at it again. The busybody liberals who want to control every aspect of your life have struck again.

This time it’s Milk. Yes, I said MILK!

The Environmental Protection Agency (EPA) is classifying milk as oil because it contains a percentage of animal fat, which is a non-petroleum oil.

Two weeks ago, the Environmental Protection Agency finalized a rule that subjects dairy producers to the Spill Prevention, Control and Countermeasure program, which was created in 1970 to prevent oil discharges in navigable waters or near shorelines. Naturally, it usually applies to oil and natural gas outfits. But the EPA has discovered that milk contains “a percentage of animal fat, which is a non-petroleum oil,” as the agency put it in the Federal Register.

Gayle Miller, legislative director of Sierra Club Michigan Chapter, said agricultural pollution probably is the nation’s most severe chronic problem when it comes to water pollution.

“Milk is wholesome in a child’s body. It is devastating in a waterway,” Miller said. “The fact that it’s biodegradable is irrelevant if people die as a result of cryptosporidium, beaches close for E. coli and fish are killed.” (American Spectator)

Dr. Thomas Sowell: Despite the old saying, “Don’t cry over spilled milk,” the Environmental Protection Agency is doing just that.

We all understand why the Environmental Protection Agency was given the power to issue regulations to guard against oil spills, such as that of the Exxon Valdez in Alaska or the more recent BP oil spill in the Gulf of Mexico. But not everyone understands that any power given to any bureaucracy for any purpose can be stretched far beyond that purpose.

In a classic example of this process, the EPA has decided that, since milk contains oil, it has the authority to force farmers to comply with new regulations to file “emergency management” plans to show how they will cope with spilled milk, how farmers will train “first responders” and build “containment facilities” if there is a flood of spilled milk.

Since there is no free lunch, all of this is going to cost the farmers both money and time that could be going into farming — and is likely to end up costing consumers higher prices for farm products.

Since there is no free lunch, all of this is going to cost the farmers both money and time that could be going into farming — and is likely to end up costing consumers higher prices for farm products.

It is going to cost the taxpayers money as well, since the EPA is going to have to hire people to inspect farms, inspect farmers’ reports and prosecute farmers who don’t jump through all the right hoops in the right order. All of this will be “creating jobs,” even if the tax money removed from the private sector correspondingly reduces the jobs that can be created there.

Does anyone seriously believe that any farmer is going to spill enough milk to compare with the Exxon Valdez oil spill or the BP oil spill?

Do you envision people fleeing their homes, as a flood of milk comes pouring down the mountainside, threatening to wipe out the village below?

So when yo spill that glass of Milk don’t forget to call in an EPA HazMat team or else you might be liable for not reporting a potential environmental disaster!

So how long before milking a cow is considered animal cruelty?? Just askin… 🙂

And since we are talking “oil” what about cooking oils like Vegetable Oil, Olives Oils, etc YOU’RE NEXT BUDDY!

And best of all, it won’t cost you time. As a matter of fact it will save you money just on Health Care…Trust Us! We are from the Government and we are here to Help you! 🙂

It doesn’t matter. Once the words are in the law, it makes no difference what the realities are. The bureaucracy has every incentive to stretch the meaning of those words, in order to expand its empire.

The Equal Employment Opportunity Commission has expanded its definition of “discrimination” to include things that no one thought was discrimination when the Civil Rights Act of 1964 was passed. The Federal Communications Commission is trying to expand its jurisdiction to cover things that were never included in its jurisdiction, and that have no relationship to the reason why the FCC was created in the first place.

Yet the ever-expanding bureaucratic state has its defenders in the mainstream media. When President Obama recently mentioned the possibility of reducing burdensome regulations — as part of his moving of his rhetoric toward the political center, even if his policies don’t move — there was an immediate reaction in a New York Times article defending government regulations.

Under a headline that said, “Obama May Find Useless Regulations Are Scarcer Than Thought,” the Times writers declared that there were few, if any, “useless” regulations. But is that the relevant criterion?

Is there any individual or business willing to spend money on everything that is not absolutely useless? There are thousands of useful things out there that any given individual or business would not spend their money on.

When I had young children, I often thought it would be useful to have a set of the Encyclopedia Britannica for them. But I never bought one. Why? Because there were other little things to spend money on, like food, clothing and shelter.

By the time I could afford to buy a set of the Encyclopedia Britannica, the kids were grown and gone. But at no time did I consider the Encyclopedia Britannica “useless.”

Weighing benefits against costs is the way most people make decisions — and the way most businesses make decisions, if they want to stay in business. Only in government is any benefit, however small, considered to be worth any cost, however large.

No doubt the Environmental Protection Agency’s costly new regulations may somewhere, somehow, prevent spilled milk from pouring out into some street and looking unsightly. So the regulations are not literally “useless.”

What is useless is making that the criterion.

Government loves useless, because it’s never useless to THEM to regulate every facet of your life.

And liberals especially love to run your life for you.

After all, you’re so bad at doing what they want you to do anyhow that they have to force you to be better. 🙂

Political Cartoon

Political Cartoon