Failure to Discuss Healthcare Reform Was Purposeful Lapse

Mark Crane

Disclosures

January 25, 2012

In This Article

Introduction

President Obama's 2012 State of the Union address included many important topics, but as far as physicians were concerned, he missed a key one: healthcare reform. To Sally C. Pipes, a longtime activist for free-market healthcare reform, that was no accidental oversight.

Pipes, president of the Pacific Research Institute, a San Francisco-based thinktank, is a staunch opponent of the Affordable Care Act, one of President Obama's top domestic legislative accomplishments. In her book The Truth About Obamacare, Pipes warns that the Patient Protection and Affordable Care Act (PPACA) will propel the nation into a socialist system similar to Canada's, with doctor shortages, long waiting times, ancient equipment, and older drugs.

Her new book, The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare, outlines measures to reform the system if the health reform act is repealed or declared unconstitutional.

Medscape Business of Medicine interviewed Ms. Pipes just after President Obama's 2012 State of the Union address.

Medscape: What is your reaction to the speech? Healthcare was barely mentioned.

Ms. Pipes: The 2700-page PPACA signed by President Obama on March 23, 2010, is almost 2 years old. This major takeover of the other 50% of our healthcare system by government was given almost no reference in the State of the Union address.

After spending more than a year focusing the agenda on his healthcare reform and being criticized by Democrats for that, it was surprising that he devoted only 44 words to healthcare in the State of the Union address.

I think it is because 53% of Americans still favor repeal of the legislation. I think everyone knows the legislation is contentious and unpopular. President Obama would not want to focus on a negative issue in a campaign year.

President Obama did say that his law supports a private market in healthcare. I disagree. He is destroying the private market and moving this country toward a single-payer "Medicare for All" system. It is not working in Canada or the UK and it will not work here. Nor will it lead to affordable, accessible, quality care for all Americans. The latest polls show that 53% of Americans still favor repeal of the PPACA.

Medscape: What will the health reform law mean for physicians in day-to-day practice?

Ms. Pipes: The man on the street thinks that most doctors belong to the American Medical Association. In fact, the AMA represents only 17% of doctors. The decline in membership is in part due to the AMA's support of Obamacare. Doctors are waking up to the fact that this brand of health reform isn't good for medicine. Numerous studies have shown that there will be a severe shortage of primary care physicians and general surgeons. Doctors are already quitting medicine early and going into other professions. That will increase under the massive number of regulations under Obamacare.

The healthcare system will become more like Canada's where there's a severe shortage of primary care doctors. No one wants to be the low man on the totem pole. At least Canadians have an escape valve; they can come to the United States and pay for care out of their own pockets.

What will happen under Obamacare is that the best and brightest minds won't go into medicine. We see already that half of graduating doctors go to work for hospitals rather than enter private practice. They become salaried employees and nine-to-fivers instead of entrepreneurs like the previous generation. Under the new Accountable Care Organizations, there will be strong incentive for doctors to cut back on the quality of care given to seniors in order to reduce costs. The Obama Administration would like to see the whole healthcare system operate this way, like a giant HMO, where the greatest rewards are for keeping costs down, not promoting quality. This will drastically change how medicine is practiced.

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