Preparing for the Collapse of ObamaCare: Some Advice on Timing for Doctors

April 22nd, 2013 By Steven Knope, MD

The difference between a hero and a martyr is timing. A hero takes charge and leads his people to victory. A martyr loses his life in defense of his beliefs. When ObamaCare collapses under its own weight, which type of doctor will you be?

Reading the Tea Leaves: Based upon several important indicators, I believe that ObamaCare will fail before it is ever fully implemented. For every physician who is running to comply with all of its new rules and regulations, stop running for a moment and think.

ObamaCare, once a mere 2,700 page law passed in the middle of the night – unread by any member of Congress – has now been transformed into a stack of 17,000 pages of rules and regulations. The number of regulations will grow. There is no way that something this complex can be followed. At a Senate hearing last week, Senator Max Baucus (an author and supporter of ObamaCare) said this to Kathleen Sebelius: “I just see a huge train wreck coming down, and you and I have discussed this many times and I don’t see any results yet.” And what a train wreck this will be…

Here are just a few reasons why ObamaCare will crash:

  1. ObamaCare is already having a devastating impact on jobs and the economy. Employers are looking for any way to avoid hiring new employees to avoid higher insurance costs. Wherever possible, employers are hiring part-time workers over full-time employees. This law alone could well drive us back into another recession, if not a depression.
  2. The law is accelerating the early retirement of many physicians. This is exacerbating a critical doctor shortage. Doctors are selling their practices or quitting altogether. It is estimated by the American Association of Medical Colleges that there will be a shortage of 90,000 physicians by 2020. That shortage will exceed 130,000 physicians by 2025.
  3. The law is still very unpopular among the public. People now know that the promise once given, “If you like your doctor, you can keep your doctor” has already been broken. Many patients will lose their doctor and their insurance plan. Several recent polls show that more than 50% of Americans still oppose the bill.

It is one thing to pass a bill of such unprecedented magnitude. It is another thing completely to make it work in practice. What I am saying is that ObamaCare, under its current form, cannot and will not be implemented. It will slowly fall apart at the seams. In the end, many of the onerous rules and regulations threatening physicians will vanish. At that point in time, there will be a huge vacuum. Many doctors will be scrambling to make decisions about their professional futures and patients will be scrambling to find a doctor in a market of limited supply.

Thinking Strategically: Though there may be some form of nationalized healthcare to replace ObamaCare when it ultimately fails, there will always be a need for good private doctors. Many patients will not be willing to see a nurse practitioner or a physician’s assistant. Medicine, like any other profession, will be governed by the laws of supply and demand. People who want to see a good doctor will be willing to pay for it, just like they do in England, where there is both a public and a private medical system. If doctors are smart, they will plan for these changes now.

Over the past several weeks, I have been approached by several specialists, asking for advice in converting their practices to a private, fee-for-service model. Many doctors want to “opt out” of Medicare. Others want to drop their insurance contracts altogether and have a direct payment arrangement with their patients. Though specialists may not be able to follow a turn-key concierge approach, good specialists will still find patients who are willing to pay them directly for excellent care. There are already cardiologists and orthopedic surgeons who are doing some form of concierge medicine or direct practices. Their numbers will grow.

My Advice: The only way to be a happy doctor is to be a free doctor; free from the constraints of third-party payers. You simply can’t be free in a system that tells you what you can charge, how many patients must see and how those patients must be treated. Anything short of breaking free of this system is a futile exercise in tinkering around the edges.

My advice to unhappy doctors is as follows: Don’t accept the “inevitability” that ObamaCare will be implemented. Don’t accept the idea that you are powerless, that your only option is to be an employee of a massive government-corporate complex. Think strategically and decide whether or not now is the time to plan for opting out of the system.

If you can see the storm clouds forming around ObamaCare, you can use the winds to chart a course to safety and freedom. If you can become a satisfied physician, who practices medicine on his/her own terms, this will not only benefit you, it will benefit everyone that you lead. You are the captain of the ship. Your freedom will benefit your family, your staff and your patients. If you prefer to be a martyr, that is of course your choice. If you prefer to surrender your life to the belief that you are somehow “helping others” by living a life of servitude, you may be comforted by the likelihood that someone will say something nice at your funeral. However, that is little consolation for all of the tireless work that you have done to become a doctor.


2 responses to “Preparing for the Collapse of ObamaCare: Some Advice on Timing for Doctors”

  1. Dr. Petersen, D.O writes:

    I am currently a PGY II in a family medicine residency program and have wanted to do a private physician type practice from the beginning. I’d love to join in with a like physician and expand a practice vs trying to start up from scratch. How do I go about this? I’m located in South Florida.

  2. Dan Cunningham writes:

    Dr. Petersen,

    I am the practice manager for my wife’s new concierge medical practice, http://www.aliciacunningham.com, which is in Burlington, Vermont. She joined the AAPP (www.aapp.org), and went to their conference in Florida. She found it extremely helpful. You may be able to find a partner there, but at the least I think you’ll get all kinds of good leads and contacts.

    Dan Cunningham
    Burlington, Vermont

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