Obamacare, with its focus on patient satisfaction, will penalize doctors on the basis of race, and may very well racially segregate doctors who swore a solemn oath to provide health care to all our citizens. It’s not that far-fetched, because even from the physician’s perspective, it simply doesn’t make sense to opt to take care of patients who are biased against them. Indeed it’s been shown that the patients who tend to give lower scores to physicians are those characterized by “minority race, psychological distress…not having a regular health care provider, not having health insurance.”

So while disadvantaged minorities with these characteristics are often most in need of good medical care, the government has misaligned the economic incentives to take care of them. “Paying doctors on the basis of popularity would create, for the first time in any profession, a system that financially rewards racism and bias,” wrote Dr. Gurley in “How Paying Doctors for Patient Satisfaction is Racist.”

To be sure, in an increasingly transparent world, patient satisfaction scores could deliver useful information. But this program is not good enough for the American people. Indeed, the surveys could help physicians improve cross-cultural communication—instead of financially penalizing them for even trying. But by tying patient satisfaction to hospital and physician pay—the government has invoked the law of unintended consequences.