Thursday, August 16, 2012

Physician Consequences of Obamacare

In nature there are neither rewards nor punishments – there are consequences.
Robert J. Ingersoll(1833-1899), Some Reasons Why
Obamacare is not only loaded with good intentions, it is burdened with unintended consequences.
August 16, 2012 –  John C. Goodman, president of the National Center for Policy Analysis and author of Crisis: Curing the Health Care Crisis (Independence Institute, 2012),  is at it again – predicting the future of physicians under Obamacare.
In “Why the Doctor Can’t See You” (Wall Street Journal, August 15), Goodman predicts Obamacare  will fail and will produce these consequences.
1.      Demand for health care will soar: the supply of physicians won’t.
2.       A two-tier system will evolve –  those without money to pay market rates will see physicians promptly – usually the day they call.   Those without money – the elderly on Medicare , the disabled on Medicare, those with low-incomes on Medicaid, and those subsidized by government – will wait, often for 2 months or more, the case now in Massachusetts. 
3.      Those who seek services  not covered by third parties (paid for by government or health plans),  such as Botox, cosmetic procedures, Lasik eye surgeries), and paying the market price will be seen on the same day or the day they request. 

4.       The physician shortage will intensify, creating a political crisis, as 30 million  Medicaid, 78 milliom baby boomer Medicare eligibles, and millions more dropped by employers,  enter the market.
5.      Concierge medicine, where patients pay $1500 to $2000 a year, for the privilege for being seen promptly by  physicians and for using the physician rather than 3rd parties as their agent, protector, and navigator,  will explode.
6.      Concierge medicine explosion will add  to the physician access crisis,  for concierge physicians can  handle only 500 patients on their panels, compared to 2500 previously under the old system’s rules of engagement.
7.      Society’s most vulnerable populations will have less access to care than before Obamacare became law.
8.      More patients,  unable to find a primary care doctor will crowded into overcrowded emergency rooms, where they will wait for hours to be seen, and 20% will leave without being seen because they can not tolerage the wait.
In other articles, blogs, and books, Goodman, who calls himself the Father of Health Savings Accounts (HSAs),  predicts HSAs will lighten the patient  load on physicians.    Patients on HSAs will think twice before seeing a doctor because they will be spending their own money out of their own savings accounts – money that would otherwise be set aside for retirement or carried over to the next year.
Tweet: In  8/15 WSJ ”Why the Doctor Can’t See You”  John Goodman predicts Obamacare will spur demands for care while decreasing supply of doctors.

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