If you like your family doctor…you probably won’t get to keep her.


Scott Gotlieb, physician and fellow at the American Enterprise Institute, has a good piece on how the administration’s health care legislation is going to kill the private practices of the real-life Marcus Welby-style docs who are family doctors: 


ObamaCare envisions that doctors will fold their private offices to become salaried hospital employees, making it easier for the federal government to regulate them and centrally manage the costly medical services they prescribe. To get this control, ObamaCare creates “Accountable Care Organizations,” which are basically hospitals coupled with local doctor networks that the hospital owns. …

The Obama plan contains other economic forces that will drive such “vertical integration” in which doctors become employees of hospitals and health plans. For one, under ObamaCare, health plans will see their revenue (premiums) and costs (medical benefits) largely fixed by government regulation. So the only way health plans can improve their profits is by cheapening the product that they provide, in other words, holding down the cost of the health coverage that they offer.



In turn, the only way to cheapen health coverage is to control the medical services consumers can access. The only way to tightly control the use of medical services is to exert more leverage over the doctors who order the tests and treatments. That means health plans will need to maintain tight networks of providers to exert more control over doctors — or else own the physicians outright. So expect to see health plans doing their own “vertical integration” — buying out medical practices, just like hospitals are doing.


The administration’s health care legislation may have scratched a certain ideological itch, but one thing it is unlikely to do is make your health care better.