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With the election coming up a a few weeks, I think this subject is worth another re-visit. Let me just preface this blog by saying that I am not opposed to Obamacare. Back in July after Obamacare passed, I wrote about my perspective as a physician of the reform. There are many good things about Obamacare. However, there will be repercussions that we can’t ignore.

This is what will happen if we continue with the current healthcare reform as it is written:

1: Although you will have insurance, it will be very difficult to see a primary care physician: In 2014, 32 million more people will have insurance coverage. To understand how difficult it will be to find a primary care doctor after 2014, look no further than Massachusetts. In 2006 the state passed a health care law mandating that everyone obtain insurance and for those unable to afford the cost, subsidies were made available. Within weeks, the “uninsurance” rate in Massachusetts dropped precipitously. Commensurate with that was a rise in both the number of “closed” office practices and the length of time it took to get a new patient appointment. Nearly six years after the law passed, more than half of the family practice and internal medicine offices in the state are closed to new patients and the average wait for a new patient to be seen by an internist is 48 days. Turns out insurance doesn’t guarantee access after all.

2) A large number of physicians will quit practicing or stop taking insurance: It is estimated that there will be a shortage of 30,000 physicians in 2014. However, the reality may be much worse. When you analyze how healthcare reform will affect access to healthcare, you must also look at how physicians will react to it.

  • 50% of physicians plan to reduce their patient volume, work part-time, switch to concierge medicine, retire, or take other steps what would reduce access to their services.
  • Over 52% of physicians have limited or plan to limit Medicare patients’ access to their practice
  • 26.7% of physicians have already closed their practices to Medicaid patients.
  • 57.9% would not recommend medicine as a career to their children or other young people
3) The cost of insurance premiums will continue to rise, threatening the promise of affordable insurance: I have not heard any politician address the issue of how to keep insurance premiums affordable. Premiums are rising and the insurance industry is warning of higher rates. How else will they continue to be profitable and pay their CEO’s? Here are a sampling of the 2011 compensation of insurance company CEO’s in case you are interested:
  • Cigna CEO, David Cordani – $19 Million (this is 94x the average pay of a primary care physician)
  • Humana CEO, Michael McAllister –  $7 Million
  • BCBS of Illinois CEO, Patricia Hemingway Hall –  $12.9 Million
And the above are only compensation of the top earners in each company. Check out the 2009 insurance industry executive compensations. In 2009Aetna paid its 6 top executives a total of $47 million dollars. Why isn’t anyone talking about this? Why aren’t people outraged?
There is a collective “burying of heads in the sand” in Washington when it comes to repercussions of Obamacare. The inevitable outcome of health reform is that coverage DOES NOT equal access to care and the only losers in this situation are doctors and patients.
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