As a physician, I would like to comment on the patient aspect of this recent court decision that has the local hospital executives so excited. This massive tax program, which is the largest expansion of the federal government since FDR's New Deal, is applauded by local hospital CEOs but is bad for patients and America.
Hospitals have placed themselves in a situation that they must serve the federal government to receive payment. In return, they are to provide compliance and more recently, patient records via electronic medical record programs (approved by the AMA) despite no proven data that electronic records improve care. By the way, the AMA also applauded and supported the court decision and this may be why the AMA membership is now less than 20% of American doctors.
The patient-doctor relationship will suffer and the small community hospital will disappear. Private insurance will be gone and the only “choice” will be government care at regional hospitals. Then healthcare rationing will begin. Just look at Canada, Mexico and England. I have experienced these type of systems firsthand. Once the physicians become employees, the real ethical challenge begins. Real healthcare reform will involve patient-centered exchanges that include patients controlling their healthcare dollars in health savings accounts and the ability to purchase insurance across state lines. Of course I am sure that people who applaud this ruling already know that those free-market choices are prohibited by this law.