Wednesday, November 14, 2012

Physicians and Employers React to Obamacare
To every action there is always opposed an equal reaction: or, the mutual actions of two bodies upon each other are always equal, and directed to contrary parts.
Sir Isaac Newton (1642-1727), Principia Mathematica: Laws of Motion
November 14, 2012 – Obamacare continues to set into motion a series of reactions among physicians and employers contrary to what Democratic lawmakers expected when they passed the Patient Protection and Affordable Care Act in March of 2010.   These reactions intensify as 2014,  the date when  the bulk of the law, becomes reality.
Thanks to a comprehensive national  Physicians Foundation survey of 630,000 physicians with 13, 575 responses we now know how physicians are likely to react to Obamacare.
n 50% of primary care doctors intend to see fewer patients over the next 3 years, some by working fewer hours, some by working part-time,  some by not accepting new Medicare patients,  some by entering  hospital employment with shorter workweeks,  some by choosing other careers, some by pursuing non-clinical positions within the healthcare industry.
n 7% plan to switch to cash-only or concierge practices to avoid 3rd party rules, regulations, restrictions, and expenses.
Whatever physicians decide to do,  physician shortages are expected to grow, from 50,000 now, to 63,000 by 2015, to 91,000 by 2020,  a period in which the number of Medicaid and Medicare patients will peak and demand for services will multiply and be magnified.
In the case of employers, reactions are expected to be to:
n  cease coverage for as many as 20 million Americans because of costs of government sanctioned plans; 

n  offer  coverage to health savings accounts with high deductibles plans in as many as 80% of businesses;

n  gear premiums to health status,  fitness measures,  obesity, smoking habits, and participation in wellness programs;

n Scale employments back to 30 hours or less instead of hiring or maintaining full-time workers to avoid the federal mandate that businesses with 50 or more employees must enroll workers in government-approved plans or incur a $40,000 fine.

n  Hire older workers covered by Medicare instead of younger workers.

According to Doug Elmendorf, Congressional Budget  Office Director, businesses may lay off as many as  800,000 workers to avoid employer mandates.  
Tweet:  Like elections, the Obama health law has adverse consequences, which include physician and employer counter-reactions.


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