by Kerby Anderson

Bob Kocher served as a special assistant to President Obama for health care and economic policy. In fact, he was the only physician on the National Economic Council advising the president. So it is remarkable that his most recent op-ed had the title: How I Was Wrong About ObamaCare. He and many others pushing the Affordable Care Act believed that the consolidation of doctors into larger physician groups would improve health care delivery and patient care. Some of his colleagues even wrote that this would “unleash forces that favor integration across the continuum of care.” The prediction about consolidation did take place. Last year alone there were 112 hospital mergers. Unfortunately, their prediction that would improve health care was wrong. The idea was that organizing medicine into these networks would lower costs and improve options for doctors and patients. It turns out that these networks are barriers to better care. A small, independent practice usually knows their patients better than any large health system can. They are also more likely to innovate and bring about change. One example Bob Kocher uses is electronic health records. The larger hospitals and physician groups have asked to delay implementation. By contrast, independent primary-care doctors are able to change their care models within weeks. It doesn’t take them years to root out waste or to redesign schedules so patients can see their doctors. These large health systems are like a big car manufacturer that can provide you with lots of options on your car. They can give you personalized options but rarely provide you with personal care. By contrast, the smaller practices can make changes faster and do provide more personal patient care. I appreciate Bob Kocher for honestly admitting that when it came to this feature of ObamaCare, he and others on the president’s team were wrong.