Audits and investigations into the effects of ObamaCare from congressional committees, government auditors, advocacy groups, and others.

“The Patient Protection and Affordable Health Care Act (PPACA) is projected to yield $575 billion in Medicare savings over the next 10 years, mostly from Medicare payment reductions to doctors, hospitals, and health plans. But beneath these payment reductions, the PPACA also makes statutory changes that could challenge the autonomy of physicians to treat patients as they think best, undercut the freedom of physicians to remain in private practice, and threaten the continuation of fee-for-service medicine regardless of the preferences of doctors and patients.”

Doctor-owned hospitals were virtually banned by ObamaCare, making them the
“biggest losers in federal health care reform.” Existing ones are looking to
merge, or be acquired by existing hospital systems, restricting choice and
competition in the market.

Many doctors acquire their own imaging equipment so they can conduct CT scans,
MRIs, and other services directly in their office without an outside referral.
They say this allows them to better treat their patients in a more timely and
efficient manner. ObamaCare put new regulations on doctors providing
self-referrals, because bureaucrats mistrust the motives of doctors, believing
them to be ordering wasteful, extra tests.

ObamaCare promises painless cuts to Medicare through savings reached via Accountable Care Organizations. These ACOs will not be successful, because they rely on heavy-handed, bureaucratic control of doctors and patients.“Accountable care organizations (ACOs) are the latest fad. They were even included in the newly passed health reform bill, whose backers expect ACOs to raise the quality and lower the cost of patient care at the same time. Detractors, on the other hand, describe them as ‘HMOs on steroids.’”

ObamaCare creates numerous expert panels to make determinations about the worthiness of many medical treatments. Supporters say these decisions will never amount to rationing, but the experience we already see with similar boards suggest otherwise. “If there’s an American precedent for the medical central planning of ObamaCare, it’s the Food and Drug Administration. Witness a looming FDA ruling that may deplete the drug arsenal for terminally ill cancer patients.Last month, an FDA advisory board recommended withdrawing government approval of Avastin as a treatment for advanced breast cancer. The decision betrays a bias that puts costs above treatment, and unless the FDA leadership overrules its own experts, the 40,000 women killed by breast cancer each year will be denied an important clinical option.”

“ObamaCare expands coverage to millions of Americans, but, warns Professor Shirley Svorny, without stronger measures to expand the supply of healthcare providers and contain costs, we can expect a physician shortage and soaring premiums. The California State University, Northridge economist suggests options for lowering costs and dismantling state-level regulations that restrain competition and innovation.”

According to an analysis by Weiss Ratings, several small insurers will be driven out of business by ObamaCare’s new restrictions. “Martin D. Weiss, president of Weiss Ratings, said in a statement that provisions in PPACA, such as the removal of certain reimbursement limits and mandated coverage for pre-existing conditions, will force health insurers to spend more on medical care. ‘Most large health insurers will be able to handle it. But we are concerned that weaker, less profitable insurers will be forced out of the market, reducing competition and ultimately leading to fewer choices and higher premiums for consumers,’ he said.”

The presidents of Texan medical schools are concerned about new costs from ObamaCare that will cause them to train fewer doctors. Teaching hospitals rely on Medicare and Medicaid patients, and they will be reimbursed less per patient by the government according to ObamaCare’s new payment schedules. Given that new insurance subsidies will drive up the demand for medical services, a restriction in supply could result in higher premium costs or rationing of care.

ObamaCare encourages preventive care, which is of dubious value and wastes the valuable time of doctors who are already stretched thin. “Several notable studies of the supply side of preventive care suggest how ObamaCare, as the healthcare legislation is often known, plans to make a difficult situation impossible. In 2003, a team of Duke University researchers first estimated the amount of time required for a primary care physician to provide then-recommended preventive services to an average patient panel… They concluded that the preventive services recommended for the U.S. population back then simply required an unreasonable amount of physician time. The authors emphasized that the large number of screening recommendations for each patient, coupled with the large numbers of patients in a practice, were likely a major reason for the failure to provide these services.”

“As businesses starts grappling with health reform, it’s becoming clearer that the Obama plan is predicated on some false assumptions about the health care industry. Three assumptions underlying the legislation are simply wrong, making it hard to see how the plan ever reduces costs. It assumes that health insurers are highly profitable, that doctors and hospitals operate on lean margins, and that the source of change and innovation in health care delivery is going to come from hospitals and medical practices that consolidate into more closed provider networks.”