There was a report issued in Modern Healthcare yesterday titled, "AMA fears privacy loss as Medicare moves to reveal Doc pay." I became aware of this because my own personal learning network brought it to my attention this morning.
In the article Joe Carlson discusses the balance between the privacy interests of physicians and the value of transparency regarding the incomes that physicians receive for services provided to their patients who have Medicare benefits. When values are in competion with each others reasonable people can certainly disagree about the nature of the "balance" between or among the values. The following statement in the news report caught my eye.
"The American Medical Association is warning that the Obama administration could violate physicians' privacy rights if it poorly implements its new policy for informing the public how much money Medicare pays to individual doctors."
The part of that statement that I notice in particular is the, "if it poorly implements" its new policy.
There is, of course, wide-spread and strongly felt opposition to the entire policy commonly known as "Obamacare." Some of that opposition is grounded in personal philosophies about the nature of freedom and the role of government. There is a substantial fundamental mistrust of central government that goes back to prior to the founding of our nation. A part of that is a pervasive belief that large governments do not have the capacity (ability and competence) to implement complex programs. Even those of us who generally favor what the new Affordable Care Act intends have concerns about the ability of "bureaucrats" to make it work well. The clumbsy roll out of the healthcare.gov website is an example that for various reasons government agancies often appears to be able than other kinds of organizations. Basically, what I see is a vicious cycle of public mistrust creating constraints upon agencies which cause agencies to appear inept that then feeds back into public mistrust and perceptions that government employees are less than fully competent.
The facts are that policy implementation is often very difficult and that implementation of "Obamacare" is a minefield of challenges because of its complexity.
I honestly don't know how to balance the privacy concerns of physicians with the need for the system to be "transparent." I do think that to the degree that being a physician is becoming more "bureaucratic," physicians are opting for early retirements. I am concerned that going forward the shortage of physicians is likely to increase.
I am here asking my students to repond to this post by sharing their opinions and insights about these things. How do the competencies of administrators affect the ability of medical providers to deliver care to large populations of people? Is it possible that "Obamacare" is so bold an initiative as to be impossible to implement effectively? I ask that my students include a link in their reply to some other relevant online resource.