As with any proposed law, the devil is in the details of the health care bill passed by the U.S. House of Representatives. At 1,990 pages, 8-1/4 inches in girth, and according to Arizona Republic columnist Doug MacEachern with the word “shall” appearing 3,425 times, the bill contains devilish details aplenty.
Dr. Eric Novack, a local orthopedic surgeon who authored the Arizona Health Freedom Act that will appear on the 2010 ballot, charges that the bill would impose chilling new regulations on physicians. A review of the pertinent provisions shows he’s right.
The bill requires any entity providing “covered items or services” to provide the government with detailed “information concerning the entity’s ownership, investment, and compensation arrangements” (p. 482). Hospitals must provide “a detailed description of the identity of each physician owner and physician investor of any other owners and investors of the hospital” (p. 483).
Under certain circumstances, the percentage of physician ownership and investment in health care facilities is not allowed to increase (p. 486); and the entity is forbidden from providing loans or financing for physician owners (p. 487). Upon requesting payment for services, hospitals and health care entities must report on the ownership share of each physician investor (p. 894).
Although physician participation in the government health care system ostensibly is voluntary, the bill contains numerous inducements and penalties to promote participation. One section of the bill, for instance, limits those who can order durable medical equipment and home health services to Medicare-enrolled physicians and other “eligible professionals,” and allows the Secretary to expand the categories of services restricted in that manner (pp. 982-83). This provision could coerce physician participation and reduce the number of health care professionals who can offer services and equipment to individuals.
Most worrisome is a provision allowing the Inspector General to obtain any information or examine any record the Act requires be disclosed (pp. 1003-04). Assurances of patient or physician privacy could be compromised by this provision.
Limiting physician freedom means limiting options for patients. The bill’s supporters have seized upon “choice” as a mantra, but the bill’s details reveal it will make health care choice an endangered species.
Clint Bolick is director of the Goldwater Institute Scharf-Norton Center for Constitutional Litigation.
H.R. 3962: Affordable Health Care for America Act