Among President Obama's broken promises, there is this gem of June 15, 2009: "No matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period."
That promise helped sway the American Medical Association to back the president's Affordable Care Act. But the AMA endorsement merely reflected a tremendous gap between its Washington lobbyists and the folks they claim to represent.
In 2011, a Jackson & Coker survey found that 70 percent of doctors disagreed with the AMA position supporting the law.
Last year, a Physicians Foundation survey found that as a result of the Affordable Care Act about three of every five physicians were "less positive" about the future of American health care, and more than a third planned to restrict their Medicare or Medicaid practice.
Doctors are demoralized and feel powerless. Obamacare never addressed physicians' most pressing concerns - particularly the need for medical tort reform. It completely ignored the already difficult problems physicians face with Medicare payments, which are below market rates.
Worse, the law created the Independent Payment Advisory Board to cut Medicare payments more.
The new law also turned the heavy flow of government red tape into a gusher. A 2012 Physicians Foundation survey found that almost four of every five respondents - 79.2 percent - identified too much regulation and paperwork as a "very important" reason the medical profession is in decline.
Consider the facts. With more than 13,000 pages of regulations thus far, and more to come, the Affordable Care Act will make running a medical practice even more stultifying and sclerotic.
In addition to the mountain of paperwork under which they already labor, doctors will be faced with reams of new bureaucratic requirements such as new Medicare rules governing patient referrals and reporting, new rules governing practice standards, plus tougher civil monetary penalties and criminal sanctions.
Even before Obamacare, America faced a shortage of physicians - particularly in geriatrics and primary care. The American Association of Medical Colleges predicts a shortage of 124,000 physicians by 2025.
Fewer doctors, meanwhile, will accept new Medicare and Medicaid patients. Expect even more doctors to abandon private solo practice, go to work for hospitals or join big group practices.
Real health-care reform would restore the traditional doctor-patient relationship. Physicians would be the key decision-makers in the delivery of care, and patients would be the key decision-makers in the financing of care.
That can't happen unless and until patients control health-care dollars and decisions, and third-party insurance executives are directly accountable to those who pay the health-care bills. In other words, that can't happen unless and until Congress repeals and replaces Obamacare.
Yes, doctors feel demoralized
Every Monday we offer pro/con pieces from the McClatchy-Tribune News Service to give readers a broad view of issues.
Robert E. Moffit is a senior fellow with the Center for Policy Innovation at the Heritage Foundation.