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The Doctor Can’t See You Now, Can You Come Back Next Year?

November 27, 2009

In the House of Representatives, Nancy Pelosi’s version of the bill designed to implement President Barack Obama’s overhaul of the American health care system (and in the process provide coverage to 30 million currently uninsured Americans and possibly illegal aliens) passed, but immediately came under fire for being too expensive. Pundits predicted that a similar version would not pass in the Senate.

Harry Reid’s Senate version of the bill had Reid’s progressives looking at what could be cut from the House’s plan in order to make the bill more financially palatable. Since Senate Democrats seem to enjoy spending other people’s money just as much as House Democrats do, they naturally didn’t find too much. One of the things they did ultimately select, however, was the elimination of those subsidies that had been allotted to financially assisting medical residents in becoming primary care physicians and general surgeons.

By eliminating these subsidies and placing more of the financial burden on future physicians, Reid and his minions reasoned that they could keep their version of the plan under a trillion dollars, thereby making its passage in the Senate more likely. The Senate version passed, and Reid and his progressives gloated before the state-run media’s TV cameras.

Both versions had one serious flaw in common: they both failed to address what a Fox News report has identified as the premier health care challenge currently facing the nation: the severe shortage of physicians.

In fact, finalizing either version of the bill will make the shortage of physicians worse. President Obama acknowledged the problem of a physician shortage last July when he commented that:

The status quo is we don’t have enough primary care physicians.

With universal coverage, the removal of the subsidies and the addition of 30 million previously uninsured persons to the mix, Obama’s health-care reform plan is going to lead to an even greater physician shortage and longer waiting times for patients.

The Association of American Medical Colleges, for example, has predicted a primary care physician shortage of 46,000 by 2025 if nothing is done; if universal health care is passed, that figure would increase by 25%.

In Massachusetts, whose health care system served as the model for the universal coverage Obama wants to implement nationwide, the percentage of residents of that state having difficulty getting care because of the physician shortage rose to 24% from 16% between 2007 and 2008.

The reason so many are having trouble finding a doctor is that since the system was implemented back in 2006, one-half of the state’s doctors have moved to other states to practice medicine. A recent poll revealed that a shocking 33% of the state’s primary care doctors are considering changing professions due to dissatisfaction with the current practice environment which forces them to deal with crushing work-loads and a massive administrative bureaucracy. In fact, Massachusetts is not only having trouble retaining doctors, it is finding it exceedingly difficult to attract new ones.

By drastically increasing patient demand while the number of primary care physicians decreases, Obama’s vision of reform will turn health care into a nightmare. There will be longer wait times, shorter visits, higher prices, and decreased patient satisfaction. In this model, patient demand can only be met with the increased use of nurse practitioners and physician’s assistants.

In September, a survey conducted by Investors Business Daily found that 45% of doctors would consider quitting medicine altogether if Congress passes its plan to overhaul health-care.

Who can blame them? Why would anyone want to pursue a career in medicine under this scenario?

  1. Carterthewriter permalink
    November 27, 2009 12:27 pm

    Drove 30 miles to a VA clinic with concerns about a lump on my neck, and wanted them to check my blood. They scheduled two appointments at a larger clinic two months later. I died first, no, but I lanced the lump myself. They were suppose to send me ear drops, too. That’s been more than a year. I decided to let nature take its course, a bit safer, too.

    It seems they create a guideline to discourage participation in any of their various existing programs which have nothing to do with compassion. That’s government health care for ya!
    (Alaskan for “You”)

  2. xqqme permalink
    November 27, 2009 1:42 pm

    From the CBO

    Bottom Line:

    “The country faces a fundamental disconnect between the services people expect the government to provide, particularly in the form of benefits for the older Americans, and the tax revenues that people are willing to send to the government to finance those services. The fundamental disconnect will have to be addressed in some way if the budget is to be placed on a sustainable course.”

  3. Melinda Moore permalink
    November 28, 2009 6:46 am

    Great article. And I agree with everything you stats are correct on the shortage. Just one correction. Please use the correct term for PA’s. It is Physician Assistant not physician’s assistant. Physician Assistant is a legal title and although we are proud to be are part of the physician/PA team we do much more than simply assist the doctor.

  4. Averal permalink
    November 28, 2009 7:50 am

    Why would anyone want to pursue a career in medicine under this scenario?

    There are countless bright young people in the country that would jump at the chance to become doctors. Being a doctor (or a Physician Assistant for that matter) is still one the “10 Best Jobs In America”. Being a doctor can be both spiritually and financially rewarding. (there are down sides to any job)

    The shortage of doctors is mostly due to the high costs of a medical education. At one time this country had a viable middle class that could aspire for their children to become doctors and improve their position in life. That middle class has been shrinking for decades. Now only the wealthy can afford such an education.

    For twenty plus years the United States has been “outsourcing” middle class American jobs. We are now paying the price for that shortsightedness.

  5. Dr. Dazzle permalink
    November 28, 2009 8:20 am

    Folks –

    Mel Martinez spoke about universal health insurance last year at our multispecialty clinic and relayed, indeed, that increased physician demand would be met by increasing training for nurse practioners and relaxing VISA requirements for foreign medical grads. Why do you think the oligarchs are exempting themselves and their families from this? And don’t forget about that massive healthcare database that the stimulus plan is funding as we speak, replete with demographic info, social (including sexual) history, family history, drug history, etc…all privacy protected, of course…

  6. John D. Froelich permalink
    November 28, 2009 8:35 pm

    Very truye! but my favorite mess within the proposals is that the “individual mandate” on insurance is UNCONSTITUTIONAL at the Federal level.

    • Carterthewriter permalink
      November 28, 2009 9:23 pm

      Thius points out precisely why AARP is in favor of this legislation. As usual, Congress has written a bill that has mandates favoring corporate interests; yet, they claimed only the Republicans favor corporations. The fact is they both enjoy the perks, to hell with the rest of us.

  7. November 29, 2009 1:43 am

    It is dangerously simplistic to ascribe the shortage of physicians to one or another philosophical approach to health care; just as the USA is afflicted with a potentially disastrous dearth of doctors, especially GPs, so are countries far to the left of centre. It is a universal and troubling problem – for some reason, fewer students than required are being graduated from our medical schools. I have neither the reason nor the solution, but I do know that it essential for all countries, regardless of political stripe, to confront and reverse this disturbing and threatening shortfall.
    I am a Canadian, and I must acknowledge that I am extremely offended by the US tv ads which cite our medical care system as an anathema. In the first place, the principal contentions are completely untrue; no one is denied medical care by his own personal physician of choice, no one is denied the most sophisticated diagnostic, medical or surgical procedures when they are required and, most importantly, health care in Canada costs far less per individual than does the same care in the United States. Opinon polls have shown that 95% of Canadians do not wish to adopt the US system in place of our own. We do have one troubling problem, which we are working very hard to overcome, and which we will sooner rather than later eliminate – excessive waiting times for surgical procedures to correct non life-threatening conditions.
    Our view is that while we believe passionately in free enterprise and individual initiative and responsibility, there are some services which function much more equitably and more efficiently under the aegis of the state. For instance, it wouldn’t make much sense to have every individual citizen be responsible for building his own part of a highway, constructing his personal square footage of his childrens’ elementary school, digging his own well or organizing and outfitting himself for his participation in a vital military campaign elsewhere in the world. No matter how self-reliant we purport to be, there are services which may only be provided efficiently by centrally administered bodies, and we believe that health care is one such service.
    In the United States, fifty million of your citizens have no medical coverage at all. There are over six thousand private insurers with wildly varying fees, coverages and caveats. The costs of a given procedure fluctuate as much as one thousand percent from jurisdiction to jurisdiction. Your medical services are so balkanized and unregulated that practitoners can charge whatever they please, with no recourse for the patient. Tens of thousands of industrious, loyal and hard working Americans, who pay taxes and unconscionably inflated medical insurance premiums, are annualy driven to financial ruin because of catastrophic health care expenses. This has never happened to anyone in Canada.
    One doesn’t need to be a Nobel mathematician to understand that when there are two identical services, one of which is for profit and the other not, that the former will cost more than the latter.


    • Dr. Dazzle permalink
      November 29, 2009 12:28 pm

      THIS IS NOT TRUE. It is the CMS (Center for Medicare and Medicaid Services) that sets physician reimbursement rates for all services. It is these rates, in turn, that all other third party payers base their contract negotiations with physicians, hospitals and surgical centers on (i.e. 90% of Medicare, 105% of Medicare). And so once again, the government creates a quasi-capitalist/socialist debacle, only to turn around and conveniently blame capitalism for its shortcomings. As for the uninsuranced, whatever their number may be, there are a multitude of potential solutions that would not cost taxpayers one cent, yet none are included in the current bills. Why?

      • Carterthewriter permalink
        November 29, 2009 1:55 pm

        Because our representatives are bought off b y special interests and the public ultimately pays the price.

  8. Paullette permalink
    November 29, 2009 6:12 pm

    JUST SAY “NO”; this is not the healthcare Americans want. We don’t buy it.

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