Spying on your doctor. Bad idea…

Why the Government Wants to Spy on Your Doctor
The Seattle Times published this op-ed on July 26, 2011
By Dr. Roger Stark, MD, FACS  |  WPC Health Care Policy Analyst

The federal government recently announced it wants to spy on your doctor. The government planned to pay “mystery patients” to call doctors and find out whether they are willing to accept the prices set by Medicaid and Medicare.

The public was outraged, naturally, and within 72 hours government officials temporarily suspended the calls.

Federal officials sending fake patients to spy on doctors is not only unethical, it is one more disturbing indicator of why government price controls on health-care services don’t work.

Medicare and Medicaid payments to doctors have been decreasing since the mid-1980s. Medicare now pays providers about 75 percent of what private insurance pays. Medicaid is worse, paying only 40 to 60 percent of private insurance, depending on the doctor’s specialty. For many doctors, especially in primary care, these low government payments do not even cover their office overhead. These disparities are well known in the health-care world, but the government either refuses to believe them or does not understand the impact low physician payment has on treatment quality.

A 2009 survey by the Washington State Medical Association revealed 30 percent of all doctors in the state do not take new Medicare patients or had decided to drop all Medicare patients because of low government payments. The survey also found that the number could increase to more than 50 percent of doctors if improvement in payments were not made.

A national survey by the American Medical Association found similar results — 30 percent of doctors polled do not take new Medicare patients. Acceptance of Medicaid patients is worse because the government pays even less to treat these patients.

So why does the government want to spy on doctors? The answer is simply because the problem of finding a doctor for Medicare and Medicaid patients is about to get much worse. The government needs to build a public case against doctors who see private-insurance patients but not government-covered patients.

The new massive federal health-care law passed last year, the Patient Protection and Affordable Care Act, will force 16 million to 23 million more Americans into Medicaid. The law also cuts $500 billion from Medicare over 10 years, most of these dollars coming from decreased payments to doctors.

It appears the government is laying the groundwork to show that physicians are the cause of the looming crisis of access to health care. The government is seeking to shape public opinion against the doctors and force them to accept markedly reduced payments.

Virtually everyone agrees the main problem with the health-care system in the United States is rising cost. Last year, the country spent $2.4 trillion, or 17 percent of the gross domestic product, on health care. This number has been increasing at twice the cost-of-living for the past 45 years.

One of the government’s solutions to the cost problem has been to impose old-fashioned wage and price controls. Doctor payments will be fixed and, potentially, doctors could be forced (through licensure requirements) to lose money by accepting patients with government insurance. From an economic standpoint, wage and price controls never work and always result in shortages and rationing.

Even if the government forces doctors to see Medicare and Medicaid patients, demand for health care will be much greater than supply and patients will be placed on lists to await treatment.

Centralized government planning has never worked for anything as complex as health-care delivery. Government spying on your doctor will not make the central planning of our health care more successful.

Dr. Roger Stark is the health care policy analyst at Washington Policy Center, a non-partisan independent policy research organization in Washington state.

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