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Independent Physicians Network 9/25/12

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  • 1. A not-for-profit health and tax policyresearch organization What’s coming and what it means for medical practice Grace-Marie Turner September 25, 2012 Independent Physicians Network /GalenInstitute www.galen.org
  • 2. www.galen.org
  • 3. Source: Ari Melber,‖POLL: Half of Americans Don’t Know How Court Ruled on Healthcare,‖ The Nation, July 4, 2012,http://www.thenation.com/blog/168720/poll-half-americans-dont-know-how-court-ruled-healthcare#.
  • 4. Americans’ views after Supreme Court decision• Americans say the health law will make things worse rather than better for taxpayers, businesses, doctors, and those who currently have health insurance.• Health care will be an extremely or very important issue for 82% of Americans in deciding their vote for the president in November.• Opposition to the law is higher now than before the Supreme Court decision.Sources: ―Americans: Healthcare Law Helps Some, Hurts Others ,‖ Gallup, July 16, 2012, http://www.gallup.com/poll/155726/Americans-Healthcare-Law-Helps-Hurts-Others.aspx. The New York Times/CBS News Poll, July 11-16, 2012, http://s3.documentcloud.org/documents/402362/jul12a-ocr.pdf. ―KaiserHealth Tracking Poll,‖ The Kaiser Family Foundation, July 2012, http://www.kff.org/kaiserpolls/upload/8339-C.pdf
  • 5. Source: Kaiser Family Foundation, July 2012.
  • 6. Americans agreed on goals for health reform… • The U.S. needs health reform to: – make coverage more affordable – assure quality, and – expand access to insurance • Most people rate their own coverage as good or excellent • They want stability. Change is for others.www.galen.org
  • 7. Taxes and spending in ObamaCareSource: Avik Roy, ―Fact-Checking the Obama Campaigns Defense of its $716 Billion Cut to Medicare,‖ Forbes: The Apothecary, August 16, 2012,http://www.forbes.com/sites/aroy/2012/08/16/fact-checking-the-obama-campaigns-defense-of-its-716-billion-cut-to-medicare/.
  • 8. Two issues:Taxes. Trust.
  • 9. ObamaCare’s New TaxesSource: Philip Dittmer and William McBride, ―Obamacares New Taxes, And How You May Be Affected,‖ Tax Foundation, July 5, 2012,http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
  • 10. More ObamaCare TaxesSource: Philip Dittmer and William McBride, ―Obamacares New Taxes, And How You May Be Affected,‖ Tax Foundation, July 5, 2012,http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
  • 11. Obamacares 7 Tax Hikes On Under $250,000-A-Year EarnersSource: Ebeling, Ashlea, Forbes Staff - "Obamacares 7 Tax Hikes On Under $250,000-A-Year Earners,‖http://www.atr.org/important-numbers-obama-a7130.
  • 12. The law fails to meet goals • Health costs and health spending increase • One-third of businesses may drop insurance • Young people worried about high cost of policies • Doctors concerned about Medicaid expansion and fraying the safety net • Seniors worried about rationing of care and finding a doctor who takes Medicare • 30 million will remain uninsured -- CBOwww.galen.org
  • 13. Some realitieswww.galen.org
  • 14. Source: Frank Hill, ―The High Cost Impact of More Regulation and Admin/Executive Staff on Health Care Inflation,‖ Telemachus, July 22, 2012,http://www.telemachusleaps.com/2012/07/the-high-cost-impact-of-more-regulation.html.
  • 15. The AMA and practicing physicians • The SGR Medicare payment fix was its key bargaining chip • The chance for a permanent fix is missed; the president got the AMA endorsement for an empty promise • Budget concerns in the Congress mean short-term fixes are likely to continuewww.galen.org
  • 16. The Doctors Co. Survey:– 60% say increased patient volume will hurt the level of care they can provide– 43% said they are thinking about retiring in the next five years– Nine out of ten said they would discourage friends and family members from pursuing a career in medicine http://www.thedoctors.com/TDC/PressRoom/PressContent/CON_ID_004671
  • 17. Physician concerns • Questions about Accountable Care Organizations • Authority of HHS Secretary to set new rules for quality of care • Regulatory requirements impacting private medical practices • More burdensome record-keepingwww.galen.org
  • 18. Specific changes to watch • IPAB — the Independent Payment Advisory Board • Patient-Centered Outcomes Research Institute and comparative effectiveness ―guidelines‖ • Physician Quality Reporting Initiative • Value-based Payment Modifierwww.galen.org
  • 19. CRS previews impact of health law on physicians PPACA has the potential to change fundamental aspects of how physicians organize, practice, and deliver care in the future. • Some of these provisions create new structures and entities, like the CMS Center for Medicare and Medicaid Innovation and the Patient-Centered Outcomes Research Institute • Others seek to develop alternatives to traditional fee-for-service payment, such as the National Pilot Program on Payment Bundling, the shared savings program (including the accountable care organization, or ACO, model), or the value-based payment modifier under the physician fee schedule In the long run, these provisions combined have the potential to be the most substantial of the PPACA and the Reconciliation Act modifications affecting physicians and related providers.Patricia A. Davis, Jim Hahn, Paulette C. Morgan, Julie Stone, and Sibyl Tilson, ―Medicare Provisions in the Patient Protection and Affordable Care Act,(PPACA): Summary and Timeline,‖ November 3, 2010, http://www.politico.com/static/PPM191_timeline.html.
  • 20. Health care in 2012 • Legislation Depends upon the outcome of the election • Regulation 13,000+ pages so far • Legal Many other court challenges continue • Political The voters will ultimately decide on Nov. 6www.galen.org
  • 21. Americans agreed on goals for health reform… • The U.S. needs health reform to: – make coverage more affordable – assure quality, and – expand access to insurance • Most people rate their own coverage as good or excellent • They want stability. Change is for others.www.galen.org
  • 22. Even Europeans going the other way • Consumerism • Value of private enterprise and competition • Doctor-patient relationship • Decentralized decision-makingwww.galen.org
  • 23. A market-based solution“Defined contributions” for health coverage A system that puts doctors and patients in charge of medical decisionsRestructuring financing for a 21st century healthsector• Medicare• Medicaid• Private Insurance
  • 24. Common themesFocus on:• Personal responsibility by recipients• Better coordination of care• Incentives for patient participation• Doctors, not bureaucrats, decide• Greater focus on patients
  • 25. Why ObamaCare Is Wrong for America How does the health care law drive up costs? Is your doctor really in charge of your health care decisions? Are your Constitutional rights threatened? Discover the law’s impact on your life in a new book from four nationally recognized health policy experts Published by Broadside Books, an imprint of HarperCollins www.WrongForAmericaBook.comwww.galen.org
  • 26. Grace-Marie Turner A not-for-profit health and tax policyresearch organization Galen Institute 703-299-8900 gracemarie@galen.org Subscribe to our free email alerts at /GalenInstitute www.galen.org www.galen.org/subscribe