Dr. Scott Gottlieb, a resident fellow at the American Enterprise Institute, writes in the Wall Street Journal that ObamaCare is positively crushing independent physicians, very much by design. The horde of little collectivist grubers who boiled forth to craft the Affordable Care Act are big believers in “consolidation,” a crusade Gottlieb entreats Republican reformers to resist:
The law’s defenders view this consolidation as a necessary step to enable payment provisions that shift the financial risk of delivering medical care onto providers and away from government programs like Medicare. The law’s architects believe that doctors, to better bear financial risk, need to be part of larger, and presumably better-capitalized institutions. Indeed, the law has already gone a long way in achieving that outcome.
A recent Physicians Foundation survey of some 20,000 U.S. doctors found that 35% described themselves as independent, down from 49% in 2012 and 62% in 2008. Once independent doctors become the exception rather than the rule, the continued advance of the ObamaCare agenda will become virtually unstoppable.
Local competition between providers, who vie to contract with health plans, is largely eliminated by these consolidated health systems. Since all health care is local, the lack of competition will soon make it much harder to implement a market-based alternative to ObamaCare. The resulting medical monopolies will make more regulation the most obvious solution to the inevitable cost and quality problems.
Kindly forgive the good doctor for referring to ObamaCare as a “law” – it’s an enabling act, rewritten at will by the lawless executive to authorize whatever he feels is politically necessary at any given moment – and consider his profound point about centralization. Contrary to popular liberal myth, Big Government planners love monopolies – provided, of course, they obey the dictates of the political elite. Forcibly restricting markets is a source of enormous wealth and power for politicians and their close friends. The modern labor union depends heavily on friendly politicians using government power to protect it from competition.
Consolidation opens two-way exchanges of money and power between big corporate entities and Big Government. Few sights warm the heart of a politician more than lobbyists working for huge, wealthy corporations approaching the altar of centralized power with their hats in hand. Big players can afford to spend big bucks currying the favor of Big Government.
Large corporate business entities are also better positioned to shoulder the burden of government …read more