Finally, patient-doctor relationships are slowly deteriorating as physicians leave private practice for salaried employment at hospitals. Last year, for the first time ever, more doctors worked for hospitals than for themselves.(Read the full text of "How Obamacare undermines the doctor-patient relationship".)
Physicians increasingly worry that a combination of government regulations and plummeting reimbursements for their services will force them out of business. Hospitals have seized upon this widespread fear and are buying up physician practices, placing the practice of medicine nationwide under their institutional control.
As a result, private practice as we know it could be extinct within a decade.
Obamacare is hastening these transactions by pushing for the creation of "accountable care organizations" whereby doctors and hospitals are paid not according to how much care they deliver but in bundles according to nebulous government "quality" standards.
ACOs are simply the 21st century version of HMOs. This time, though, doctors will be forced to serve their hospital paymasters -- not their patients...
A physician being employed by a hospital is not inherently bad. But when hospitals are subjected to financial sticks-and-carrots by the government to require their doctors to practice according to government algorithms, and when government also creates incentives to drive doctors away from private practice and into hospital chains (such as with burdensome new electronic medical record requirements), this can be a deadly combination.
In that case, the hospitals are merely the intermediaries for the government -- serving as the indirect agents of rationing. But for the patient, the end result will be just as bad.