Senate Republicans want to create a top watchdog to dig into ObamaCare.
GOP Sens. Pat Roberts (Kansas) and Rob Portman (Ohio) have introduced legislation that would create an Office of the Special Inspector General for Monitoring the Affordable Care Act (SIGMA).
The Department of Health and Human Services (HHS) already has an inspector general, but Roberts said he wanted to create a position that could investigate ObamaCare across the federal government.
“While all of the federal agencies charged with implementing Obamacare have their own Offices of the Inspector General, they are all investigating this law in their own silos,” Roberts said in a statement. “The Health and Human Services Inspector General isn’t talking to the Treasury IG, or the Department of Labor IG, or the Homeland Security IG.”
The legislation would give SIGMA the authority to “conduct, supervise, and coordinate audits and investigations of the implementation and administration of programs and activities established under, and payment system changes made by, the Affordable Care Act,” according to the legislation.
Under Obamacare, doctors have been strained by costly new regulations, intricate payment “reforms” that tie their Medicare reimbursement to complex federal reporting requirements, and mandates that they install and make “meaningful” use of electronic health records.
Add a new burden to the mix: The proportion of patients they see are rapidly shifting away from commercial health plans and toward Medicaid, which sometimes pays doctors pennies on the dollar that they were previously reimbursed under private insurance.
The data comes from ACAview, a product of athenahealth that aims to measure the impact of Obamacare on medical practices. The project, jointly funded with the Robert Wood Johnson Foundation, is the first large-scale examination of data derived directly from outpatient medical practices belonging to more than 60,000 providers. It gives a unique insight into how the Affordable Care Act is impacting patients at the point of care.
About a decade ago, a doctor friend was lamenting the increasingly frustrating conditions of clinical practice. “How did you know to get out of medicine in 1978?” he asked with a smile.
“I didn’t,” I replied. “I had no idea what was coming. I just felt I’d chosen the wrong vocation.”
I was reminded of this exchange upon receiving my med-school class’s 40th-reunion report and reading some of the entries. In general, my classmates felt fulfilled by family, friends and the considerable achievements of their professional lives. But there was an undercurrent of deep disappointment, almost demoralization, with what medical practice had become.
The complaint was not financial but vocational — an incessant interference with their work, a deep erosion of their autonomy and authority, a transformation from physician to “provider.”
Even as federal regulators take steps to constrain administrative spending by private health insurers, government overhead on health coverage has soared.
In a Health Affairs blogpost published Wednesday, David Himmelstein and Steffie Woolhandler use actuarial estimates from the Centers for Medicare and Medicaid Services to project that between 2014 and 2022, national spending on private insurance overhead and government administration will rise by $273.6 billion related to the health-care overhaul.
The authors both favor single-payer health insurance; Mr. Himmelstein co-founded Physicians for a National Health Program, an advocacy organization directed to that end. They close their piece by saying that “In health care, public insurance gives much more bang for each buck.”
Yet overhead in the public sector is growing much faster than in the private sector.