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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 Jeffrey Colyer, also blamed PPACA for additional bureaucratic burdens and said it should be repealed.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 uninsured.
“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 protection?”
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.”
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