NCMS Analysis of Health System Reform Law and Reconciliation Language

The North Carolina Medical Society has evaluated the Patient Protection and Affordable Care Act of 2010, signed into law by President Obama earlier today – as well as the reconciliation bill that modifies this law to be debated by the Senate in the coming days. 

The NCMS recognizes the positive measures of this law that expand coverage to more uninsured individuals, eliminate bans on pre-existing conditions and the primary care-based initiatives that would promote prevention and wellness.  However, the positive results of these reforms will be overshadowed by disabling actions taken by this bill including:

  • A failure to permanently repeal Medicare’s flawed physician payment formula. 

  • A failure to enact meaningful medical liability reform. 

  • A failure to allow physicians and patient rights to privately contract without penalties. 

  • The imposition of penalties for physicians who do not successfully participate in the Physician Quality Reporting Initiative (PQRI). 

  • The creation of a Medicare Independent Payment Advisory Board (IPAB). 

  • Ban the establishment of new physician-owned hospitals.

NCMS has addressed these concerns repeatedly throughout the process with the entire Congressional delegation. Staff as well as physician leadership have visited individually with the North Carolina Congressional delegation to ensure that your voice was heard during this debate.

For a copy of the NCMS bill comparison, click here.  This document will be updated on our site as the reconciliation process continues.  Please feel free to offer questions, comments, or feedback via this blog.


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  • Michael March, M.D.

    I have to shake my head in disbelief, Dr. Zacher. God gave you a brain to become a physician; yet why is it so difficult for so many physicians to understand the ills of a statist society? Why? How much do you have to go through to understand?
    All I hear is an adult crying in his cornflakes that “the government didn’t give me anything”. When a government is big enough to give to everything, it’s big enough to take it all away (or withold it). They’re not interested in making you happy. They’re not interested in insurance companies. They simply use people, and categories of people, to assume control. You buy into leftist code words that are not about helping people, they are about assuming power and transforming a society of people that freely contract into a nation of dependents.

    Welcome to 21st Century slavery in America.
    You voted for Obama? You wanted “meaningful” reform? Well, this is certainly meaningful. It means that someone who pronounces “amniotic fluid” as “antibiotic fluid” will decide whether your wife deserves an ob ultrasound, because the friendly Medicaid clerk will soon be your healthcare arbiter (true story). Thanks for voting for Obama!!

    I’m a solo Ob/Gyn with a family, so I empathize with the “work all night”, “man in trench” mentality. Medical care is under attack; however, I have more than monetary riches. PlEASE, Praise the Lord, and vote correctly next time.

  • Brad Huggins

    Oh yes, they did. All payors will still insist on and get the use of CPT codes from the AMA, the only thing they were truly interested in. Regular physicians should band together, take the name from them, and rename them the Am Coding Assoc.

  • Allan N. Zacher, MD

    This is outrageous! This bill is CHRISTMAS in March for insurance companies and drug companies but doctors got nothing! Not even lip service to controlling the liability lottery for lawyers and any kind of reasonable guarantee of future payments to physicians.

    How dare the congress pass this bill, basically written by and for insurance and drug companies (yeah! THEY really need a government sponsored bailout!) and not listen to the voices of those at the junction of rubber and road.

    We are getting squashed by this process while the insurance brass laugh all the way to the bank with $100,000,000 retirement packages.

    WE are the people working all night to care for people in dire medical needs, trying to always make the correct medical decision sometimes in split-second life or death situations. All the time worried that if “grandma” dies of a stroke she was going to have anyway that the family will sue us for millions of dollars – and in the meantime, the insurance companies are risk free to deny coverage for a CT scan.

    As my teenage daughter would say, WTF!

    The snake you have grown will come to bite you in the assets when there aren’t any doctors anymore.

    But then it will be too late.

    By the way, these comments are coming from a working physician who is IN FAVOR of MEANINGFUL health care reform, a genuine public option and who voted for Obama.

    Now that I see the system, both parties have been bought and sold by the insurance and drug companies, you can expect I’m going to change careers.

    Probably I’m going to get a job in the insurance industry. The HECK with caring for patients for less than a muffler shop owner makes.


    Allan Zacher, MD
    Clyde, NC

  • Virginia Scanlan

    The AMA, for all its support of this bill, has gotten nothing to protect doctors’ practices and to fix the Medicare reimbursement process. This is an astonishing demonstration of incompetence and naivite. You are being held hostage by the government and you don’t even know it. Representatives of every health related industry extracted their price for support. The AMA got nothing.