Ed Haislmaier, a health care researcher at the Heritage Foundation in Washington, DC, said Obamacare will accelerate the decline in doctor-owned private practices because more doctors will only accept patients who can pay in cash, leading to fewer clients and fewer private practices.
“I think we are going to see primary care doctors increasingly moving to a cash-only arrangement, where they opt out of insurance rules,” Haislmaier said. “Primary care specialists, those on salary, will increase versus those who are in effect independent contractors, assuming these reforms actually happen and are not altered or repealed.”
The new reforms also require the inpatient admissions of physician-owned hospitals to match or exceed the average admissions in all other county hospitals, have a bed occupancy rate greater than the state average, and be located in states where bed capacity is below the national average.
“Clinical practice doctors are moving toward positions of those in research and management—all those same divisions—so you will see some shift to those things,” said Haislmaier. “Make no mistake, some doctors who are in private practice are going to start to do something else or go somewhere else if Obamacare is not altered.”
Diana Furchtgott-Roth, a health policy analyst at the Hudson Institute in Washington, DC, says these requirements will further reduce the number of doctor-owned medical practices in the country and encourage doctor unionization.
“They have set up the system to fail, and to eliminate entrepeneurial approaches to medicine,” Furchtgott-Roth said. “Step one is to get more and more people into the Medicaid program, and private practice doctors do not want to take Medicaid. So federal or state governments are going to have to hire many doctors to cope with all the new demand, and those doctors are going to be unionized.”
“The long-term goal of many of the people who have imposed Obamacare is to put the provider side of health care in the public sector,” Graham said. “It is putting medical providers in hospitals, nursing homes, and other areas under government control, and having them deliver their service according to a very centralized system. That system will probably demand a high level of unionization or quasi-unionization and drive out private practice.”
yes there are interesting trends emerging in health care delivery and ocare will drive them along. they might save the insurance companies, we'll have to see. there are ways around ocare. but they are already in trouble with docs especially with so many going to medicaid. medicaid struggles to serve what they have and the temporary fee bump for pcps isnt helping as much as they had hoped. of course it was never intended to work, only create a manufactured crisis to attempt to make single payer seem to be the only alternative. then things really will turn to poop.