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Columbus Dispatch...
Editorial:
Extreme demand
No survey needed to show that
health-care law will worsen doctor shortage
Wednesday, June 29, 2011
The
United States faces a daunting
shortage of doctors, a problem that President Barack Obama’s
health-care overhaul
would critically exacerbate as it seeks to provide 32 million
additional people
with health insurance. That total includes 16 million expected to sign
up for
Medicaid, the federal health-care program for the poor.
Officials
are recruiting “mystery
shoppers” to pose as patients who phone doctors and see how difficult
it is to
get an appointment. The stealth survey also seeks to determine whether
doctors
favor patients with private insurance and turn away those with
government-reimbursed health care, which pays doctors less than the
cost of
providing the care.
“Is
this a good use of tax money?
Probably not,” Dr. Robert L. Hogue, a family physician in Texas, told
the New
York Times. “Everybody with a brain knows we do not have enough
doctors.”
It
also is well-established that many
doctors already limit the number of patients whose health-care is paid
for by
the government.
The
real problem is that the issue of
doctor supply should have been studied before the health-care overhaul
mandated
a huge increase in demand, not after.
But
this law was never about sound
policy. It was about politics and presidential bragging rights. A
Democratic
congressional majority used a moment of dominance to impose a hugely
expensive
and widely opposed new social program on the nation. The president saw
it as
the keystone of his legacy.
Though
the results of the overdue
patient-access study are predictable, what the administration will do
with them
is not. The Patient Protection and Affordable Care Act hinges on having
enough
doctors to treat the newly insured. Otherwise, people will continue to
seek
care in hospital emergency rooms, the most expensive option.
Solutions
are limited:
•
Train more doctors. This cannot be
done overnight, and certainly not before Obamacare becomes operational
in 2014.
Physicians complete four years of college, three years of medical
school and
three to eight years of residency training.
•
Increase Medicaid and Medicare
reimbursement rates to give doctors a greater incentive to take the
flood of
patients Obamacare will enroll. That would cause costs to skyrocket,
further
discrediting the White House’s already-bogus claims of savings from the
health-care overhaul.
•
Require or pressure doctors to
accept patients. This would be the most Draconian solution, but hardly
outside
the realm of possibility. Obama already claims the power to compel
Americans to
buy health-care insurance on the grounds that the program only works if
all
participate. It would be a short step to require doctors to provide
care under
the same rationale.
The
Association of American Medical
Colleges projects Obamacare will worsen physician shortages by more
than 50
percent, starting in 2015. By 2020, the nation will be short 45,000
primary-care physicians and 46,000 surgeons and specialists.
“The
United States already was
struggling with a critical physician shortage,” the association says.
“And the
problem will only be exacerbated as 32 million Americans acquire
health-care
coverage, and an additional 36 million people enter Medicare.”
The
survey is yet more proof that this
half-baked, wholesale restructuring of the American health-care system
should
not have been rushed, behind closed doors, by politicians with no input
from
those on the front lines of health care.
Further
straining the situation is
that baby boomers are aging, and the need for specialists will
increase. But
doctors also are aging, the association says: “Nearly one-third of all
physicians will retire in the next decade, just as more Americans need
care.”
It
doesn’t take a brain surgeon - if
one is available - to see that trouble lies ahead.
Read
it at the Columbus Dispatch
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