Posted on 03/24/2010 10:50:12 AM PDT by iowamark
Health-care reform is a fact. And in spite of some continuing congressional squabbles and legal skirmishes, the outlines are clear. More than 32 million Americans will be able to buy affordable health coverage when the program gets going in 2014. In fact, they will be required to carry insurance.
Many people will be covered even sooner. The government is going to set up a $5 billion insurance subsidy program in the next 90 days, to cover those who are uninsurable because of a previously existing medical condition.
The really challenging question about health-care reform is will there be physicians and clinics to take care of all this new demand for medical care? (Getty Images)
Immediately, children under age 19 will receive coverage because they cannot be disqualified from insurance as a result of a pre-existing condition. And young adults can stay on their parents' policy until age 26.
State Medicaid-funded programs will now be told to cover an additional 16 million low-income people -- a mandate that does not come with federal funding, and which will have a huge impact on states currently struggling with budget deficits. It's not just the money
The obvious question is: Where will we get the money? The Congressional Budget Office finagled the numbers, subtracting money from payments to doctors who see Medicare patients, and making deep cuts in the Medicare Advantage program, which is a successful HMO for seniors.
Congress has promised to raise taxes on those who currently have good health-care plans, which will result in higher premiums. Plus they'll increase taxes on everything from earned income to investment income to come up with money to subsidize this new health-care reform.
But ultimately, just as with all other promises, the government will resort to "printing" the money -- creating new credit to pay off on all these promises.
As obvious and frightening as that prospect is -- leading to inflation and higher interest rates -- it's still not the scariest question. Where are the docs?
The really challenging question is: Will there be physicians and clinics to take care of all this new demand for medical care?
In a free-market society, you could be sure that higher prices would certainly be an incentive to create more neighborhood health-care clinics. The chance to serve profitably all these new patients would create incentives for more people to go into the medical profession.
But remember, most of these new patients will be covered by programs created by the government -- programs that set limits on reimbursement for services.
Already, seniors are learning that physicians are simply "not taking on any more Medicare patients at this time." Quite simply, the current Medicare program doesn't pay enough to cover the cost of care, plus the administrative costs.
State Medicaid programs are already in dire straits. Hospitals, physicians and clinics are waiting months for the state to pay its bills. Are they willing, or able, to accept more Medicaid patients?
The real issue is whether there will be enough trained health-care professionals to meet the new demand.
Dr. Russell Robertson is chair of Family and Community Medicine at Northwestern University Feinberg School of Medicine. He has advised Congress and the Department of Health and Human Services on issues related to physician supply and distribution. And he is working on a program to expand training of physicians and assistants in family medicine.
Dr. Robertson is very concerned about who will care for the influx of new patients who now will have insurance coverage: "We now have only four years to make sure that we have enough health-care providers to actually deliver on that promise as at the present, we are in short supply. . . . This is a special challenge in Illinois as we do not yet know the effect on physician supply after the state Supreme Court's lifting of the medical malpractice caps."
After the applause stops, the reality will set in. It's not the cost; it's the access. We aren't rationing health care. But we're surely going to be rationing access to physicians and medical services unless we create some incentives to increase the supply of healthcare providers. And that's The Savage Truth.
(Terry Savage is a registered investment adviser.)
Absolutely, positively, without a doubt, certainly
NO !!!
This is what I’ve been yelling for months now. I work with 400 physicians... many, many many are retiring early.
Interesting that this guy is trusted to advise people on their finances.
The only ‘docs’ I want to see are the ones Obama is hiding.
I guess we'll have to pass a law that forbids doctors and nurses from declining anymore patients even if they're already dangerously overwhelmed...oh, and the mandate to improve the quality of care? that still stands too. so, yeah, you have no choice but to absorb the new patients and if they don't receive the same, nay, BETTER care than they did prior to the influx, the government won't reimburse you for your work. That should put most nursing homes out of business.
Unless you mean negative reform you are not correct. What was passed was an insurance and student loan takeover and big government expansion into your life requiring a massive addition to the governments police force ( 16500 gun wielding IRS agents) and acquisition of your personal medical, and banking records. Little if anything was actually done to improve health care...for anyone.
This one had planned to work another 10-15years. I’m thinking about only 5 more years if this goes into effect as planned.
This one had planned to work another 10-15years. I’m thinking about only 5 more years if this goes into effect as planned.
Don’t you think somewhere in some back room, Obama’s gang stands ready to bring in lots of docs from India (and other countries) to fill the void?
They will practice medicine for less money, I think.
Some of the physicians here were talking about that.
It’s not so simple. Somehow emigrating half way around the world to a bankrupt dying empire may not be so attractive anymore. The whole world can see what is happening, and Indian docs are not stupid.
trust me, we already do
I know one brillant kid who is seriously considering changing his plans to enter medical school next year. He’s been accepted and now he is scared of the “profession.”
New version of HC bill found
Establishing a Ready Reserve Corp
http://www.freerepublic.com/focus/f-news/2478605/posts
http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf
He should definitely NOT do it. He will be saddled with huge debt and will not be able to pay it back (if he’s joe blow average med student).
But if the government pays for moving and pays you a salary, might be a good thing.
Also, is buying into a concierge plan any advantage to people that can afford it? (not for any cost benefit, but for access)
Are you in a specialty where you could practice in a direct-service plan?
This whole thing is a complete nightmare. We just have to repeal it... we have no choice.
No problem. The government will import physicians from Sri Lanka, China, and Zimbabwe to fill their slots.
Response: This pending problem will be cured by the importation of medical doctors from Bangladesh and Haiti. The doctors from Haiti will be especially desireable as the feathers in their ebony masks and the beads on their rattles are pretty.
Because it has gone from MAGNIFICIENT OBSESSION to NIGHTMARE BUREAUCRACY.
That and it appears that his government student loans will come with a civilian/military service requirement - two years “service” for one year loan.
The poor kid is melting down at the moment as he analyzes the 2,000 pages and consults with his dad who is a doctor who can retire now any time he decides to. He is not alone in this panic. Other friends who were planning to enter medical school next year with him are in the same freak out boat. Sad for Americans... The decline is already in motion.
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