Physician Patient

ACA Whoppers

MPPA applauds the desire of HHS Secretary Sylvia Burwell to trust her doctor. She says she wants her physicians to be paid to help her get quality, person-centered medical care. And she correctly notes that in 2016 government and private payers do not pay doctors for patient-centered health care, and that today most physicians are overburdened by third party care rules including coding for pay and burdensome clinical record documentation requirements.

Burwell’s desire is to pay doctors for the best care they can give to patients. But the proposed “Quality payment Program” she is promoting actually bypasses patients and families as the critical judges of their personal health care quality. Rather than trusting patients, the federal government would determine what quality health care is and financially reward the hiring organizations of physicians who will need to faithfully document their compliance with the new payment rules causing more administrative burden for doctors, not less.

Such promises are yet more ACA political whoppers! Recall President Obama’s pledge to the American public when selling the 2010 Patient Protection and Affordable Care Act (ACA): “If you want to keep your doctor, you can keep your doctor.” Well, how has that worked out?

Now four more lies: 1. “Doctors will be able to practice as they always have.” What is the evidence for this? 2. “When [doctors] get better health results [as measured by the government] and reduce the costs of care for their patients [as measured by the government], they receive a portion of the savings.” This creates a clear-cut conflict of interest and challenge to the physician’s Hippocratic oath to work for patients and do no harm. 3. “We’re giving doctors more freedom to practice the way they were trained, the way that makes more sense to them and is best for their patients.” Doctors are trained to act in their patient’s best interests, not their own. 4. “We’re helping to put people at the center of their care.” Quite the contrary, these rules would actually remove patients and families from this opportunity and responsibility.


Like many people, I rely on my doctor. I trust her to help me make some of the most important decisions in my life. I have come to her sick, worried and scared, and she has given me comfort, hope and a plan for protecting myself and my family.

America is home to world-class doctors. They train for years to understand the ins and outs of our health and the best way to care for each of us. But in today’s health care system, we often don’t pay for the best care they can give.

This video explains:

In the last few years, we’ve made tremendous progress to transform our nation’s health care system into one that works better for everyone. Key to this effort is changing how we pay doctors, so they can focus on the quality of care they give, and not the quantity of services they order. For years, people across the health care system have agreed that we need to improve the status quo. The Affordable Care Act created new tools to encourage innovation and help us improve how we deliver care. And now, the “Quality Payment Program,” the result of a bipartisan bill passed last year and supported by much of the medical community, strengthens these tools and gives us new ones.

Today, we announced the first step in this program, a proposed rule to guide its implementation. As the video explains, it does two things:

First, it replaces our patchwork collection of incentive and penalty programs with a single program where every doctor has the opportunity to be paid more for better care. Doctors will be able to practice as they always have, but will also have the chance to get paid more for high quality care and investments that support patients.

For doctors who want to go further, there is a second option that’s even more flexible. They can decide to be a part of new organizations that get paid primarily for keeping people healthy. For example, they could be part of an “accountable care organization” where doctors, hospitals, and other health care providers come together in one organization to coordinate high-quality care for the patients they serve. When they get better health results and reduce costs for the care of their patients, they receive a portion of the savings.

With these changes, we’re giving doctors more freedom to care for patients the way they were trained, the way that makes the most sense to them and is best for their patients. And we’re helping to put people in the center of their care.

Change isn’t easy, and this is just the first step in a complicated process. We know the transformation we’re working toward won’t happen overnight, and we know it might be challenging. That’s why we are working with experts in the medical field, doctors, nurses, hospitals, insurers and patients. We’re listening to our partners and working to make sure we get this right.

Efforts like this are important steps on our path to a health care system with better care, smarter spending, and healthier people. Through this work, we can build a health care system that works better for everyone.

—HHS Secretary Sylvia Burwell

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