The Detroit News published Dr. Don Condit’s Acton commentary on Accountable Care Organizations (ACOs) in today’s paper. The ACOs are designed to manage costs under the Patient Protection and Affordable Care Act, better known as Obamacare.

Medicare beneficiaries will be “assigned” to 5,000 patient-minimum organizations to coordinate their care. While HHS Secretary Kathleen Sebelius talks about improvement in care, the politically poisonous truth is that Medicare is going broke and ACOs are designed to save money.

The words “rationing” or “treatment denial” or “withholding care” are not part of her press release, but reading the regulations reveals intentions to “share savings” with those who fulfill, or “penalize” others who fall short of, the administration’s objectives. The administration’s talking points include politically palatable words that emphasize quality improvement and care enhancement when the real objective is cost control by a utilitarian calculus.

Physicians and other health care providers will find themselves in conflict with the traditional ethos of duty to patient within ACOs. Doctors will face agency conflicts between the time honored primary duty to patient. Medical care providers will receive incentives for controlling spending, and penalties if they do not. “No one can serve two masters” (Matthew 6:24); not even physicians.

Read “Obamacare rules belie compassion, care” on the Detroit News website.

  • Kurt Hahn

    If anyone wanted a reason to scrap Obamacare the new regulations on Accountable Care Organizations are. First the Federal government will assign people to a particular ACO not based on their desires but based on a 3 year retrospective look at who provided their care. The Accountable Care Organization reinbursements are based on progressively lower amounts every three years based on a combination of shared saving reductions and 65 Federal quality measures applied to orimary care doctors. There is a built in strong financial disincentive to transfering as patient to a Teaching Hospitals and other Center of Excellance so the often feared Healthcare Rationing will soon become a reality especvially for those who are cancer patients or have a complicated medical condition. As a member of a Hospital Board of Directors I cannot think of a worse environment for both doctors and hospitals.

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