How Smart Physicians Can Reap Rewards with Obamacare

The political face of Obamacare is an ideological battle of demonization and power. For one side, it is fairness and fair share, spreading the burden and controlling “out-of-control costs” forced upon a helpless populace by greedy insurers, doctors, hospitals, and big pharma lining their gilded pockets. For the other, it is a government plot to take over and control one-sixth of the gross national product, a train wreck in the making, a failed model made worse and a pox upon the people.

The perfect plot for a Sci-Fi B-movie sequel to “Sharknado”: “Obamanado!”

And, just as much fiction.

Not the political battle, as that is quite real, but because the claims on both sides are simply absurd if only because the institutional complexity and incompetence of the Federal government makes them so.

The reality is different, and the signs are there. The realization that controlling prices to manage a spending problem can be no more effective than restricting a compulsive shopper to only buy items that are on sale seems to be taking hold. Some quarters of CMS are coming on board, and more are likely to follow. Controlling spending by modifying behavior instead of price is becoming a deeply rooted idea with private insurers.

The real life fact of the matter is that the powers that be, whomever one believes them to be, can only have the power if one agrees.

Therein lies Obamacare’s gift to physicians.

Don’t like the rules? Don’t play. Why? Because they can’t make you. It’s the law.

Don’t like the game? Make a new one.

Like this one: Form a narrow regional network of physicians and providers, get everyone on the same clinical page with the right tools and processes, go to the dominant insurers and offer to share savings 75-25 with you keeping the 75 percent. Partner with a hospital or two and some ancillary care providers and provide quality care dictated by your professional judgment and that of your peers and partners, not ignorance, big government boogiemen, the press, or trial attorneys.

Insurers won’t be able to get the paperwork to you fast enough, and will let you keep the pen. CMS is hungry for success stories for ACOs, too, and they need and deserve them because the theory is sound. It is just the execution that is wishy-washy and poor - a strong argument that serves neither side in the political battle.

New players and experienced ones will help you through the process and even partner with you.

It beats the alternative…