The views expressed by contributors are their own and not the view of The Hill

ObamaCare fails to uphold the hippocratic oath to ‘do no harm’

As medical professionals, we are all expected to swear by the centuries old Hippocratic oath, “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.”

Unfortunately, as a result of the passage of ObamaCare, providing quality healthcare services is no longer the primary focus of the healthcare community. The main focus is on cost containment and whether or not a specific condition meets specific criteria as determined by unelected bureaucrats and academic experts. Another focus is on the physician’s documentation providing sufficient information to justify a specific code. The attending physician’s clinical judgment about each patient’s unique situation and needs is secondary to meeting the correct criteria.

{mosads}I have seen this transformation firsthand. I have been a Registered Nurse for the past 36 years and have been specializing in the field of clinical appeals for the past 12 years. As a clinical appeals nurse, my job is to review denials that have been generated by insurance plans for medically necessary healthcare services provided to patients in the hospital setting. Since the implementation of ObamaCare, the rate of denial for payment for care has exponentially increased. This has left many hospitals operating in the red as the healthcare services they provide in good faith are challenged for medical necessity. This is especially true in regards to the ObamaCare exchanges. 

What one would have considered “standard healthcare services” just five years ago are now considered medically unnecessary care. As previously stated, the focus of healthcare is on cost containment. There’s another term for this and it’s “value based care.” In other words, the physician’s judgment is now challenged and questions are raised as to whether or not he may have ordered unnecessary services, and/or did the service meet standardized criteria or evidence-based medical literature? The emphasis is on the best bang for the buck, but not necessarily on quality care to treat a condition.

Some examples of these denied services include inpatient care for Appendectomies, Coronary Bypass Graft surgery, Abdominal Hysterectomy, Hip/Knee Replacement surgery and countless others. These are now deemed “medically unnecessary” and should have been treated at a “lower level of care”.  By lower level of care, the insurance company (especially government run insurance plans such as Medicare, Medicaid and ObamaCare exchanges) generally mean at a Skilled Nursing Facility or as an Outpatient.

Imagine receiving postoperative care after your bypass graft surgery at a Skilled Nursing Facility. That would be considered outrageous and medically dangerous for anyone. However, that is exactly what we are being asked to accept under government run insurance programs because it is not about delivering the best healthcare, just “adequate” healthcare as President Obama described before the passage of ObamaCare. 

Imagine going into the hospital with shortness of breath, chest pain and typical symptoms of a heart attack. Once the medical team has treated and stabilized your condition and you are sent home, oftentimes the payment for the care at the hospital is denied because an outside entity has determined that the care was not necessary as deemed by the treating physician. 

America used to have the best healthcare system in the world.  We were told that we needed to pass ObamaCare because 30 million people were uninsured. Ironically millions still remain uninsured, more people cannot afford the law’s “affordable” insurance plans, and the American people are expected to accept less service for the higher cost of care. It grieves my heart to see the harm that is being done under the guise of providing healthcare to all.

If we do not change course, we will continue to witness the collapse of quality medical care replaced by a government run single-payer system. The Hippocratic Oath is swiftly becoming the hypocrytic oath.

Nadia White is a registered nurse in Orange County, California.


The views expressed by authors are their own and not the views of The Hill.

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