Dr. Terry Gerard, an emergency room physician from Durant, Oklahoma, entered the medical field with the intention of helping people. However, he has found that the increasing bureaucracy and regulations imposed by health insurance companies and regulators are hindering his ability to provide care to his patients. Dr. Gerard expressed his frustration, stating that he spends more time helping insurance companies get paid than he does actually treating his patients. He believes that this bureaucratic barrier not only diminishes the quality of care he can provide but also creates a disconnect between patients and doctors.
Dr. Brian Miller, an assistant professor of medicine at Johns Hopkins University, testified before the House Committee on Small Business’s Subcommittee on Oversight, Investigations, and Regulations on July 19. He proposed a simple solution to address Dr. Gerard’s conundrum – allowing physicians to own hospitals. Dr. Miller argued that enabling physicians to compete fairly on a level playing field would alleviate the burdensome regulations imposed on them and increase their ability to provide quality care.
Historically, physician-owned hospitals (POHs) were common until Congress severely restricted doctors’ ability to own hospitals in 2003 due to concerns about potential conflicts of interest and increased costs. However, a recent study by the Mercatus Center at George Mason University suggests that these restrictions have had the opposite effect. The study found that POHs offered higher-quality care at a lower cost and greater efficiency. The study recommends that policymakers reconsider the restrictions on POHs to revitalize competition in the hospital market.
Dr. Miller further highlighted that burdensome regulations from entities like the Centers for Medicare and Medicaid Services (CMS), private insurers, and state and federal laws are causing many private medical practices to struggle. CMS alone has over 2,000 rules and guidelines for doctors, making it nearly impossible to run a business efficiently. This excessive bureaucratic burden has pushed many physicians out of private practice and into employment with corporate hospitals, resulting in decreased competition, increased costs, and a decline in quality of care.
Members of the House Committee, such as Subcommittee Chair Rep. Beth Van Duyne (R-Texas), were shocked to hear that doctors are spending up to 90 percent of a patient visit entering information into a computer to comply with regulations. The excessive time spent on compliance and administrative tasks takes away from the core mission of treating patients effectively.
Dr. Henry Punzi of the Trinity Hypertension and Metabolic Research Institute echoed these concerns, stating that the “red tape” doctors face distracts from their ability to provide accurate diagnoses. He emphasized that correctly diagnosing patients is crucial for reducing healthcare costs in the long run.
While it is clear that administrative tasks increase costs, Dr. Matthew Fiedler, a senior fellow at the Brookings Institution, cautioned against completely dismantling the system. He acknowledged that regulations and administrative processes serve valuable purposes, such as preventing unnecessary procedures and redundant care. However, he also acknowledged the need to strike a balance between necessary regulations and burdensome bureaucracy.
Dr. Fiedler recommended specific areas that could be reformed or eliminated, such as preauthorization, arbitration processes, and standardization of billing and coding, among others. He emphasized the importance of carefully examining each regulation to ensure that it provides appropriate protections without becoming overly burdensome.
In terms of potential solutions, Rep. Roger Williams (R-Texas) proposed the use of telehealth, especially in underserved rural communities. Dr. Miller acknowledged that telehealth can be a valuable tool but stressed that it is not a complete substitute for in-person care. He argued that the best solution is to restore competition in the healthcare market and reduce the regulatory burden, allowing doctors to work with insurers and hospitals without interference.
In conclusion, the increasing bureaucracy and regulations imposed on doctors by insurance companies and regulators are creating barriers that hinder their ability to provide quality care. The restrictions on physician-owned hospitals have had unintended consequences, reducing competition and increasing costs. Reforms are needed to strike a balance between necessary regulations and burdensome bureaucracy, with a focus on restoring competition and reducing the regulatory burden. Telehealth can be a valuable tool, but it is not a complete solution. Ultimately, doctors need the freedom to provide care without excessive interference in order to truly help their patients.
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