Wednesday, November 14, 2012

Ehhh....What's Up Doc?

Now that it appears the Affordable Care Act will remain in place, I'd like to welcome the 38-million Americans that were supposedly unable to get health coverage before to the ranks of the insured.  Now, good luck finding a doctor.  As anyone who has been required by their insurance carrier to get an annual physical to maintain their lower premium rates can tell you, getting in to see a general practitioner isn't easy.

ABC News touched on the subject yesterday citing reports that the US will need to add 52-thousand family practice physicians over the next ten years or so just to keep up with additional demands of the newly-insured and the aging Baby Boomers.  Consider it the first (of what will be many) unintended consequence of the ACA--the current medical system can't handle the anticipated demand created by requirements in the law.

The study points out that in Massachusetts, where RomneyCare (the blueprint for ObamaCare) is in effect, it takes ONE YEAR to get in to see a primary care physician--despite the fact the state has the second highest physician-to-patient ratio in the country.  When those conditions come here to Wisconsin, I guess we will all just have to have a standing appointment date just to get that annual physical--and self-refer ourselves to a specialist in case anything else comes up the other 364 days.

And speaking of specialists, they are apparently the ones to blame for this.  Medical school graduates are flocking to specialized practices--featuring higher salaries and reduced patient loads--in order to pay off their student loans as soon as possible.  General practice has become the "WalMart Cashier" of the medical world--too much work for not enough pay.

An expert quoted in the ABC story has the answer--of course--more government spending.  Specifically, "incentives" for med school grads to become family doctors--including student loan forgiveness and income supplements immediately after graduation.  Plausible solutions, until you consider that the Affordable Care Act achieved its "budget savings" by further reducing Medicare and Medicaid re-imbursements--effectively guaranteeing that family doctors will get paid even LESS for seeing MORE patients.

And let's not forget, throwing around more government cash still doesn't provide an immediate fix to the problem.  Unlike tech school training for other high-demand fields like welding and machining--becoming a doctor is not a six-month program you can complete on Saturday afternoons.  There is a reason why it takes eight years of college to become a physician--and why new docs have to go through a residency program after that: because being a doctor is very hard.  Especially in a legal atmosphere where one misdiagnosis can result in multi-million dollar lawsuit awards (which is why the ACA didn't address tort reform).

At least we can all "feel good" that everyone will have health insurance now--even though it won't be any easier to actually use to really "feel good".

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