This week, Jane Orient, M.D., executive director of the Association of American Physicians and Surgeons (AAPS) offers Physicians Practice readers insight into the group’s latest challenge to the Affordable Care Act (ACA) announced Oct. 28, 2013.
Martin Merritt: What is the AAPS’ challenge to the ACA about?
Jane Orient: The separation of powers requirement in the Constitution prohibits the Obama administration from rewriting the laws. Only Congress is authorized to make law, not the executive branch. Someone needs to stand up against the Obama Administration rewriting the laws, and the AAPS is taking the lead.
We believe the employer and individual mandates are void, i.e., non-existent, based upon the failure of Congress to adhere to the lawmaking procedures specified in the Constitution. Article I, Section 7 prevents: (1) the Senate from originating revenue bills, id. at cl.1 (“Origination Clause”); and (2) Congress from simultaneously enacting a provision and revision of that provision within the same bill id. at cl. 2 (“Presentment Clause”). The ACA is so long and complicated, and its final amendments were drafted and inserted with such haste, that many fine and conscientious members of the House and Senate did not recognize that the Origination and Presentment Clauses were violated by the enactment of the mandates. Compliance with these constitutional provisions is not optional.
MM: AAPS opposition to the ACA should come as no surprise to anyone following the arc of Obamacare. Your organization has been one of ACA’s most outspoken critics. What is it specifically about the law that you find objectionable?
JO: Since 1943, the AAPS has been dedicated to the highest ethical standards of the Oath of Hippocrates and to preserving the sanctity of the patient-physician relationship. The physician cannot serve two masters — the third party and the patient. The ACA greatly expands government intrusion into medicine, attempting to dictate what services may be offered and even how the medical record must be kept. It spells the end of confidentiality and greatly restricts patients’ freedom. It is deliberately designed to “transform” medicine. The Oath of Hippocrates is seen as an impediment.
MM: If something isn’t done to rollback or repeal the ACA, what do you think the future holds for physicians?
JO: Physicians who are not able to escape the tentacles of the ACA and maintain a direct relationship with patients will be government serfs, spending most of their time and energy complying with bureaucratic diktats. Attempts to put patient interests first will be punished by pay cuts, fines, and even exclusion from practice. As true insurance is destroyed and Americans are impoverished, few will have the means to escape the compulsory, overpriced “health plans” in which they are entrapped. Many physicians will close their practices, either leaving medicine or becoming wage slaves to big organizations accountable to government or government-controlled paymasters. The most capable young people will avoid medicine. Increasing amounts of wealth will be squandered on activities of no benefit to patients, and politics will be a constant feature as various interests fight over access to diminishing resources.