Sunday, May 26, 2013


Obamacare: Wait and See and Waiting to Be Seen
Change will not come if we wait for some other person or some other time.  We are the ones we’ve been waiting for.  We are the change we seek.
President Barack Obama, campaign speech, 2008
Americans are an impatient people.  We do not like  like waiting.  We do not like waiting to schedule an appointment to see a doctor.  We do not like  waiting in the waiting room. We do not like wasting a day driving to and from the doctor,  or waiting to find a parking spot, waiting to fill out the paperwork at the doctor’s office, waiting to be seen by the doctor,  waiting to have the prescription filled,  or waiting to see what to see what the Affordable Care Act portends for us.
When 2014 arrives, Americans will have waited four years to see what Obamacare holds for them.  That’s a long wait for an impatient people.   There are hints on what is to come.  Massachusetts has a health bill resembling Obamacare.  In Boston, people now wait 2 months to see a doctor (versus 3 week in the rest of the U.S.),  and  1 in 5 Boston patients leaves the emergency room without being see because they are tired of waiting.
The waiting situation will only grow worse when 2014 comes, when 32 million more patients enter the system courtesy of Obamacare,  and when over the 4 years between 2010 and 2014, the population has grown by 10 million or so and 16 million more aging  Americans will have joined the Medicare ranks,  the doctor shortage will have grown to 50,000,  and 75% of doctors will be working 40 hour weeks as hospital employees. In the 4 years since Obamacare passed, the demand for care will have grown while the supply of doctors to see them will have shrunk.
So what happens in 2014 and what is happeining now?  Well, according to John Goodman, writing in the May 23 issue of Forbes,  “Coming Soon to America: A Two-Tiered System Canadian-Style System,” we’ll have a two-class system. 
·         In the first class system,  i.e, those who can pay  $1500 to $2000 a year,  for the privilege of not waiting, patients will go to concierge doctors, who will see them on the day they call – no waiting there.   Doctors who practice in this system will have pared their patient panels from 2500 patients to 500 in order to give patients the attention they deserve and to eliminate waiting time.  The other 2000 will just have to wait to be seen elsewhere.

·         In the second class system for those on Medicaid, those on Medicare unable to afford the concierge fee, those  on federal subsidies of one sort or another,  or those who simply can’t afford to pay for one reason or another ,  there will be rationing by waiting, whether that be at the doctors’ office, community health centers,  or hospital emergency rooms.
 
The end game will be a waiting game.   Those who can will advance to the head of the line;  those who can’t will go to the end of the line.   Don’t worry, if you are one of the less privileged one, “All things will come round to him who will but wait, ” as William Wadsworth Longfellow (1807-1881)  said in Tales of A Wayside Inn (1863).  You will just have to wait by the wayside  to be seen, and  meanwhile,  you may  have to wait a year or more to see if waiting for Obamacare to come full-bore has been worth the wait.
Tweet:  A 2-tier health system is evolving; one for those with who do not have to wait to be seen , another for those who must wait to be seen.

12 comments:

Anonymous said...

Hаѵе уou evеr thοught аbοut
аdding а little bit moгe than just уouг агticles?
I meаn, whаt you say іs fundamental and all.
Вut think of if you аԁdeԁ some gгеаt images оr ѵiԁeo clips to give youг posts more, "pop"!

Your content is ехcellent but with іmagеs аnd viԁeοs, this blοg coulԁ certаinlу bе onе of thе bеst in itѕ nichе.

Good blog!

Here іѕ my wеb ѕіtе
hotel-discount.com

Anonymous said...

Hey there are using Wordpress for your blog
platform? I'm new to the blog world but I'm trying to get started and set up my own.
Do you require any html coding knowledge to make your own blog?
Any help would be really appreciated!

Look at my web blog ... Rvtl Anti Aging Solution

Anonymous said...

Hi! Someone in my Myspace group shared this website with
us so I came to give it a look. I'm definitely loving the information. I'm bookmarking and will be
tweeting this to my followers! Outstanding blog and excellent design and style.


My web site; raspberry ketones review

Anonymous said...

Hаving read thiѕ I believed it ωаѕ verу enlightening.
ӏ apрreсiate уou fіnding the
time anԁ effοгt to put this ѕhort aгtіcle togetheг.
I once аgаin find myself pеrѕonally sρending
a signіfіcant аmount οf time bоth reading аnd poѕting comments.
But ѕo what, іt was ѕtill ωorthwhіle!



Fееl free tο visit my sitе ::
Low cost Holiday accommodation A number of Simple Tips about Having the Very best Hotel Special discounts

Anonymous said...

I've been exploring for a bit for any high-quality articles or weblog posts in this sort of house . Exploring in Yahoo I eventually stumbled upon this site. Studying this info So i'm glad to express that I have an incredibly
excellent uncanny feeling I discovered exactly what I needed.
I most for sure will make certain to do not overlook this web site and give it a glance regularly.


Also visit my page; Internet Money Path Reviews

Anonymous said...

Hi, I do think this is a great web site. I stumbledupon it ;
) I am going to return yet again since I bookmarked it.
Money and freedom is the best way to change, may you be rich and continue to help other people.


Also visit my site: Online pay day loans

Anonymous said...

Hi there, I desire to subscribe for this blog to get newest updates, therefore where can i do it
please help out.

Visit my blog post; Work from home

Anonymous said...

Hmm is anyone else encountering problems with the images
on this blog loading? I'm trying to figure out if its a problem on my end or if it's the blog.
Any suggestions would be greatly appreciated.

my web site Dead Sea Kit Moisturizing Cream

Anonymous said...

Thаnks for еvery other infoгmative web sitе.
The plаce else cοuld ӏ gеt that kіnd
of info ωritten in suсh аn іԁeal manner?
I hаve a ргoject that I am simρly nоw operаtіng on, аnԁ
I've been on the glance out for such info.

my homepage; First Amount Pricing On Very last Moment Resort Rooms

Anonymous said...

This post is really a fastidious one it helps new the web users, who
are wishing in favor of blogging.

Look at my weblog Mito slim

Anonymous said...

Every weekend i used to pay a quick visit this web page, for the reason that i want enjoyment, since this this website
conations truly fastidious funny material too.

my site: thinning hair products

Anonymous said...

Νο matter if some one seаrсhеs fοr his essential
thing, therefore he/ѕhe needs to be available that in detaіl, theгeforе
that thing is maintained over here.

my webpаge: Lookup Discounts Hotels prices