Why Obama Would Be Good for Doctors

Harris Meyer

Disclosures

October 25, 2012

In This Article

Independent Doctors

Other Obama supporters note that the current free-market model is hurting independent doctors who lack bargaining leverage, with many opting to work for hospital systems and larger groups. "Left on its own, the market will kill small private practice, no matter what doctors want to believe," says Robert Berenson, MD, a general internist and health policy fellow at the Urban Institute in Washington, DC.

In contrast, he points to the Accountable Care Organization (ACO) demonstrations launched under the ACA, which lets groups of private physicians band together to streamline care for beneficiaries in traditional Medicare and share in any cost savings if they meet quality targets. Many ACOs have been started by physician-led groups without hospital involvement.

"The ACA set up tests of alternative payment approaches that put doctors back in control of their fate," Dr. Berenson says. "So I think the law provides promise of a better healthcare system in which doctors will have greater satisfaction in their practice."

Obama's approach to Medicare and Medicaid is also better for doctors, Obama supporters argue, because he will preserve the programs as guaranteed benefits, providing patients with certainty that they'll have access to care when they need it. In addition, his reform law enhanced Medicare's preventive and drug coverage and extended the solvency of the program. In contrast, Romney's Medicare voucher proposal means that people "don't know whether they'll have access to affordable care when they are old and sick," says Steve Kagen, MD, an Appleton, Wisconsin, allergist and former Democratic congressman who's proud of his vote for the ACA, which he calls the most important legislation in a century.

Similarly, he adds, Romney's Medicaid block grant plan would "allow states to turn their back on people in need. What kind of nation would we be if we turned our back on children who are ill? By not paying providers their overhead for taking care of people in need, you're turning your back on the community and on providers delivering lifesaving care."

Effect on Society Beyond Doctors

More broadly, physicians who support Obama feel that his economic policies are better for all Americans, and that's good for doctors. "As doctors, we're dependent on a successful middle class, and our best opportunity is expanding the middle class," Dr. Kagen says. "In my view, Obama has the best plan to expand the middle class, by investing in education, clean energy, and infrastructure. Then I'll do better."

Dr. Berenson adds that even though physicians might benefit financially from Romney's proposals to cut taxes for wealthier Americans, "they wouldn't be very happy with a society marked by increasing disparities between the rich and poor, more crime, and more demands on public funding for food and shelter. That's not a world I want to live in."

Regardless of their tax bills, he says that doctors' professional interests lie more with Obama and the Democrats because "at least Democrats are trying to do something about the obvious problems in the healthcare system, while I've seen no evidence that Romney and the Republicans have any views of what should happen. Romney passed a very good law in Massachusetts, he's proud of it, but he can't tell anyone because his party is so Neanderthal on the issue."

The bottom line is that doctors who back President Obama strongly prefer his focus on ensuring that all Americans have access to healthcare and a way to pay for it. "I assume doctors mostly go into the profession because they want the personal satisfaction of improving the health of the public," Dr. Berenson says. "The obvious benefit of Obama's law is that it sets up an environment where doctors can feel proud that they are working in the health system."

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