Thursday, November 17, 2011

Killing Small Medical Practices

Walter Russell Mead discusses how ObamaCare is killing small medical practices in his 11/15/2011 blog post, "Big Oil, Big Pharma, Big Obama?"

Mead notes:
The rise of enormous, super-empowered HMOs closely tied to government regulations suggests we are headed further in the direction of building a corporatist, medico-industrial complex whose powerful lobbies will fight reforms, abuse monopoly powers and further congeal the American health care system into an unmanageable and unaffordable form that will undermine living standards while providing ever-less-satisfactory care.
He also wonders whether this is a deliberate policy or a so-called "unintended consequence". (Read the full text of "Big Oil, Big Pharma, Big Obama?".)

I offered my own thoughts on this topic in my 7/11/2011 PJMedia piece, "The Coming Collectivization of American Health Care":
The Obama administration regards this collectivization of medical providers as a desirable outcome, not merely some "unintended consequence." As Obama health advisor Nancy-Ann DeParle wrote last year in the Annals of Internal Medicine, the new law will "accelerate physician employment by hospitals and aggregation into larger physician groups" and "physicians will need to embrace rather than resist change." Translation: "Doctors should get with the program -- or else!"

Furthermore, such collectivization is merely a continuation of a much older strategy. Jonah Goldberg's book Liberal Fascism described how the Roosevelt administration sought similar consolidations of American agriculture and business during the New Deal. As Goldberg noted:
[If] you want to use business to implement your social agenda, then you should want businesses themselves to be as big as possible. What's easier, strapping five thousand cats to a wagon or a couple of giant oxen?
Similarly, it will be much easier for the federal government to regulate 100 large ACOs than 10,000 small private practices.
(Read the full text of "The Coming Collectivization of American Health Care".)

Regardless of whether this is a deliberate policy or not, the end result will be the same: the stagnation of American medicine as doctors are increasingly compelled to practice according to the dictates of their bureaucratic masters, rather than according to their independent minds.