Malcolm Ing MD
Malcolm Ing MD

BY MALCOLM ING MD – It may surprise the public to learn that the majority of doctors oppose Obamacare. These physicians are particularly in opposition to the section of the new Affordable Care Act that has created the Independent Payment Advisory Board, a 15 person committee of non-physicians appointed by the President.

In fact, even the AMA, which was acquiescent in the passage of the Obamacare before it became the Law, supported the failed House of Representatives effort to rescind this portion of the Law.

Unfortunately, this effort was defeated in the Senate. However, by now, everyone with common sense realizes that this section of Obamacare will forever threaten the sacred doctor- patient relationship

In addition,  thefailure to address steeply rising drug and technology costs and the absence of tort reform to decrease necessity to practice defensive medicine were important omissions in Obamacare.

Taking personal responsibility by maintaining a healthy lifestyle and health savings accounts are not encouraged by government control of medical insurance and payments to hospitals and physicians.

To make matters worse, Medicare now requires physicians to utilize expensive (at least, $35,000) electronic health records for patients to avoid paying a financial penalty.

Ironically, just when the country will need more physicians to provide medical and surgical care especially to the elderly, the government plans to add to the costs of providing that care. All this is taking place while Congress is failing to address the chronic problem of Medicare underpayment to physicians (SGR) which limits the number of elderly patients that doctors can accept in their practices.

It should be no shock to learn that, when surveyed, many physicians consider the increased bureaucracy as motivation to retire early which will aggravate the already recognized doctor shortage. By 2014, an additional half billion dollars will be removed from Medicare funds that are barely keeping the program afloat as it is.

Lastly, the medical insurance requirement for physicians to utilize the more complicated insurance coding also by 2014(ICD-10), necessitates more cost and personnel to maintain medical practice.

Anyone who has truly studied all these factors will realize that they are the elements of an impending perfect storm for medical care in this country.


Malcolm R. Ing, M.D. is a comprehensive family ophthalmologist with special training in the diagnosis and treatment of eye problems in children. Dr. Ing received his pre-medical training from Harvard University, graduated from Yale Medical School and completed his Ophthalmology training at Yale University.  Dr. Ing enjoys teaching at the John A. Burns School of Medicine at the University of Hawaii and serves as clinical Professor and Chair of the division of Ophthalmology.