Unfunded Mandates

The frustration of physicians of the endless unfunded mandates in an attempt to control health care costs is mounting.  An opinion piece in the Wall Street Journal by a 58 year old orthopedic surgeon is an excellent example of these complaints heard in any medical gathering.  The article a doctor's declaration of independence, elucidates the various complaints.  These include the electronic medical record with all its attendant problems, meaningful use demands for unnecessary clinical data to obtain payment, decrease of face to face time with patients, board recertification, and continual decrease in reimbursements by Medicare and Medicaid.

His suggestion is to stop taking Medicare or any insurance.  The problem is that Medicare and Medicaid pay approximately 30% of the total health care budget.  This is probably a low estimate, but without these funds hospitals would be unable to remain open.

When Medicare started in 1965, physicians and hospitals "hooked their wagons" to the government for higher and consistent reimbursements.  But like any government program, the system is constantly evolving in a negative entropy that appears to be unable to be stopped.  More regulations and more burdens are now the norm.

There is no easy answer for these problems, but physicians need to organize to protect their workplace environments only one of which is financial.  Hating the job is not in the patients' interest.  Their health and care is really the ultimate goal.