Doctors Wish List for Health Care Reform

The Issue:  Health care costs too much.  

It should not be this way because true cost is typically far less than current charges. 

The Reason:  There is no price transparency, so patients are disconnected from costs.

Healthcare is inexpensive to deliver. It is everything that gets between the patient and the doctor that drives up costs – the hospital, the lack of competition, the red tape that doctors have to deal with that increases their overhead and takes them away from their patients, the high cost of drugs, defensive medicine, the “handcuffs” placed on doctors which prevents them from innovating and creating value. 

The current trend has driven doctors out of business. Almost 65% now work for hospitals. Over 15% of medical school graduates will not see a patient in their career. Doctors are burning out and retiring much earlier than ever before. Private practice of medicine is in grave danger.

What can be done to help patients and doctors and to drive down costs?

1. Enforce & strengthen the Primary Care Enhancement Act – uncouple HSAs from insurance so patients can use it for Direct Primary Care. Clarify DPC as a delivery model and not a risk bearing entity

2. Remove anti-physician provisions from ACA (surgery centers, ACOs, IPAB)

3. Relax/repeal Stark laws

4. Fix the Medicare payment system which reimburses hospitals more for services than those delivered outside of the hospital

5. Repeal MACRA

6. Repeal HITECH – these 2 laws have created unnecessary and burdensome regulation and red tape that are putting doctors out of business

7. Promote charity care with tax incentives to providers

8. Protect doctors and patients from having to participate in treatments that violates their conscience

State level issues critical to the overall goals

9. Protect doctors from predatory specialty societies who have colluded with hospitals and insurance companies and force them to pay money to “maintain their certification” (MOC) as conditions to work treating patients

10. Repeal Certificate of Need (CON) laws to foster competition/innovation

11. Meaningful Tort Reform which would put an end to “defensive medicine”


  1. How much of this well thought out list was included in the blocked Republican effort?
    We should add to your list above some PATIENT focused changes, instead of all doctor-focused changes. How about elimination of the requirements for prescriptions for all but antibiotics? How about massively curtailing the FDA’s overreach? How about opening the doors to foreign competition against the pharmaceutical companies? When freedom comes, let it come to the doctors AND the patients, whom we doctors currently insist on monopoly prescriptions rights over, yes? Does not the blocking of the Republican effort (which seemed again focused on health insurance subsidization as opposed to health care) open the door for some resurgence among republicans to start focusing on freedom as the central philosophy instead of control? President Trump was right when he said that health care is highly complicated. It is far too complicated for Congress to plan. President Trump is doing the job of getting government out of the way within the power he has executive. It is in the hands of Congress to seek out and change the laws that intrude on the individual freedoms of Americans, whatever those laws may be, and that includes FDA and federal involvement in support for prescription controls. Elimination of prescription requirements will save Americans oodles of money and assure competition. Or do we doctors think like congress–that we are so brilliant that we should COMPEL patients to use us as their advisors?

  2. Great list of things that need to be done for meaningful reform of medicine in this country!

  3. I would say that the Stark Laws seem to have actually allowed a lot of self-referral within health systems because so many of those regulations had exceptions for health care systems. They have certainly done nothing to foster real competition.

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