By Mindy Yochelson
Republican members and their witnesses at a July 10 House subcommittee
hearing attacked the Patient Protection and Affordable Care Act as a federal
intrusion into patient care that discourages physicians from remaining in the
profession and which, inevitably, will make it harder to find doctors.
The health reform law “destroys the doctor-patient relationship,” Richard A.
Armstrong, chief operating officer, Docs4PatientCare, a national physician
advocacy group, said during the hearing of a House Committee on Oversight and
Government Reform panel.
Armstrong, a surgeon from Michigan, told the hearing on “Examining the Impact
of ObamaCare on Doctors and Patients” that doctors should be free to do what
they were trained to do and not coerced by a central authority into various
activities that take away time from practicing medicine.
He cited electronic health records, accountable care organizations, and the
Independent Payment Advisory Board among those provisions that will create
“bureaucratic and financial burdens.”
Rep. Trey Gowdy (R-S.C.), who chairs the Subcommittee on Health Care,
District of Columbia, Census and the National Archives, said the law's
“regulations and administrative requirements … only serve to distract and delay
a doctor's primary objective, which is to provide care to patients.” He warned
that “a significant doctor shortage is on the horizon.”
Committee Chairman Darrell E. Issa (R-Calif.) agreed that the law is “driving
out doctors from practicing” because they are choosing to retire “rather than
live under ObamaCare.”
Another hearing witness, Kansas Lt. Gov. Jeffrey Colyer, also blamed PPACA
for additional bureaucratic burdens and said it should be repealed. “We need to
start over before irreversible damage is done to patients, taxpayers, states or
the fiscal health of the United States.”
Colyer, also a surgeon, criticized the law's expansion of Medicaid. An
experiment to do so in Kansas about a decade ago, aimed at cutting the number of
uninsured, he said, resulted in more government spending and more
“Designed as a mandate, this expansion, even though now optional, potentially
poses high costs to the states,” Colyer testified. “The Congressional Budget
Office estimated that over the next decade the expansion will cost states $73
billion,” he said.
A majority of the U.S. Supreme Court recently ruled that states must be able
to opt out of PPACA's Medicaid expansion without any threat of losing their
current federal Medicaid funds (125 HCDR, 6/29/12).
Since the court's decision, governors in Texas, Florida, Mississippi,
Louisiana, and South Carolina have announced they will not participate in the
Medicaid expansion (131 HCDR, 7/10/12).
Colyer said Kansas has not decided about participation.
The sole witness in favor of PPACA, Ron Pollack, executive director of the
consumer group Families USA, said passage had been supported by a wide variety
of physician groups, including the American Medical Association, the American
College of Physicians, and the Association of American Medical Colleges.
He listed a series of consumer-oriented provisions in the law, including
closing the Medicare Part D drug benefit coverage gap; prohibiting insurers from
denying coverage based on a pre-existing condition; and prohibiting gender-based
premium discrimination--and asked after each: “Why would we want to repeal that
Pollack said that “in 2006, under the leadership of [Republican] Gov. Mitt
Romney, the Commonwealth of Massachusetts passed comprehensive health reform
designed to provide universal health care for its citizens.”
He said the state law was successful and has served as a model for PPACA.
Rep. Danny K. Davis (D-Ill.), the subcommittee's ranking member, criticized
the Republican members' witness choices.
“Curiously, the majority did not invite a single doctor or patient from
Massachusetts,” he said. “Perhaps the majority knows that you will not hear
complaints from physicians there.”
In addition, no patients were invited to testify, Davis said, and Democrats
were allowed only one witness.
Issa said Democrats invited Pollack “as an apologist for ObamaCare” and
called his responses to questions “obstructionist.”
The contentious hearing took place the week the House was expected to vote to
repeal PPACA (see related article).
Although the vote will not get rid of PPACA, Rep. William Lacy Clay (D-Mo.)
said it will signal “what would happen if Republicans were to win the White
House, the Senate, and hold onto the House.”