|ObamaCare and the Doctor Shortage|
By Ashton Ellis
Thursday, January 10 2013
What if 20 million Americans get mandated health insurance, but there aren’t enough primary care doctors to serve them? Thanks to ObamaCare’s mandated expansion of insurance coverage, that’s exactly what will happen as the law exacerbates a nationwide doctor shortage.
Just after the November elections, the Robert Graham Center for Policy Studies in Primary Care released a study projecting that the United States will need at least 52,000 additional primary care doctors by the year 2025 to meet the demands of three developments: overall population growth (33,000 new doctors), the aging of the Baby Boom generation (10,000) and ObamaCare’s insurance expansion (8,000).
You read that right. The cost of ObamaCare’s mandated insurance expansion is nearly the same as the added expense of caring for America’s largest elderly population in history.
The reason ObamaCare’s impact is so dramatic is because the law extends health insurance to roughly 20 million uninsured Americans starting in 2014. The move will be accomplished through an enormous expansion in Medicaid eligibility. Instead of showing up at emergency rooms, the newly insured will seek out primary care doctors.
But will there be enough of them to meet the demand?
Primary care physicians are the family or general practice doctors who serve as a patient’s medical “quarterback,” directing treatment decisions to specialists and overseeing the results.
Unfortunately for patients, becoming a primary care doctor is an increasingly unpopular career option for medical students. A 2008 census by the Association of American Medical Colleges and the American Medical Association revealed that medical school graduates choosing a career in primary care dropped 27 percent between 2002 and 2007.
Factors contributing to the decline include increased patient loads and stagnant or decreasing compensation levels. Technology also plays a part, enabling family doctors to perform complex (and costly) tests that patients expect, but not at a price that third party insurers (private or public) are willing to pay for fully. Most often, the doctor gets squeezed. Throw in the longer working hours and mountains of red tape, and it’s no wonder today’s medical students shy away from primary care.
Then along came ObamaCare with its health insurance expansion that, as a matter of policy, intends to increase the number of patients able to see primary care doctors. This disconnect with reality was apparent enough to prompt ObamaCare’s authors to increase the financial incentives for medical students to choose primary care as a career.
But those enticements are dwarfed by the monetary hit primary care doctors will continue to take under the health reform law. On average, ObamaCare leaves in place the 56 percent compensation rate for Medicaid visits, and creates a new price control panel (the Independent Payment Advisory Board, or IPAB) with further power to reduce payments to doctors.
Add all these pieces together and it’s easy to see why surveys show that 84 percent of doctors feel their profession is in decline, while 43 percent are moving up their retirement to avoid the costs of doing business under ObamaCare.
Unless changes are made soon to reverse the decline in primary care doctors, Americans – those who already have insurance and those newly benefited under ObamaCare starting in 2014 – will encounter European-style waiting times to see a general practitioner. Ailments that could be treated easily with prompt care will get worse, and people will die from preventable illnesses.
For a look at what’s coming, consider RomneyCare in Massachusetts. Despite the state’s rank as second-highest in its ratio of primary care doctors to population, Bay State policymakers are finding it impossible to make health care both universal and efficient. Since RomneyCare went into effect in 2006, wait times to see a primary care doctor have risen to one year.
As one observer says, “Coverage does not equal access.”
Too bad the liberals in Washington aren’t listening.
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