Posted on 03/28/2010 8:02:26 AM PDT by KeyLargo
Patients will have coverage, but no doc
March 27, 2010
BY LOUIS J. GOODMAN AND TIMOTHY B. NORBECK
Now that the health-care bill has passed and the smoke has cleared from the acrimonious debate -- if only for a little while -- it seems appropriate to reflect on how this significant legislation will impact our health-care system.
We don't know anyone who would oppose, on moral grounds, insuring everyone, and that includes us at the Physicians Foundation. Some have argued that the overall cost of the legislation may be prohibitive. While that argument goes beyond our expertise, we do believe that there is an important issue that has been ignored.
Many groups and think tanks seem to agree that there is a shortage of practicing physicians in the United States, especially those in primary care. These entities, including the Association of American Medical Colleges, point to what they see as serious shortages of as many as 100,000 physicians over the next 10 or 15 years.
The Physicians Foundation is a nonprofit organization created in 2003 to help physicians, in an increasingly difficult practice environment, to continue delivering high-quality health care. In 2008, the foundation, in collaboration with Merritt Hawkins & Associates, undertook a comprehensive survey of all primary care physicians in the U.S. The results were dramatic and distressing regarding difficulties they are encountering in sustaining their medical practices.
What was also telling and relevant to the discussion on the physician work force were the following:
63 percent said increasing paperwork has caused them to spend less time per patient.
76 percent said they were either at "full capacity" or are "overextended and overwhelmed."
Less than 6 percent assessed their colleagues' morale as positive, and 78 percent reported that over the past five years, the practice of medicine has become less satisfying.
Because of these factors, 49 percent of physicians reported that, over the next one to three years, they intended to reduce the number of patients they see or to stop seeing patients entirely due to retirement, working part time or seeking non-medical jobs.
The entire survey is at www .physiciansfoundation.org. It is also available in a new book, In Their Own Words, in which physicians explain growing impediments to the delivery of patient care, including difficulty working with managed care organizations; liability insurance/defensive medicine; non-clinical paperwork; increasing demands on time; onerous government rules; declining reimburse- ments as their practice costs are escalating, and a shortage of primary care physicians. In view of the influx of 30 million more insured patients into our health-care system, these findings are sobering. How will there be enough doctors available to take care of everyone?
For the past 25 years, the number of physicians completing training in the U.S. has remained flat at about 24,000 a year. During that time, a handful of new medical schools has been added, and enrollment is gradually increasing. The Association of American Medical Colleges has initiated a plan to increase medical school enrollment 30 percent by 2015, but that won't help unless the number of medical residencies available for them, now fixed by law, is increased as well.
To its credit, Massachusetts attempted to insure all of its citizens in 2006. According to the Massachusetts Medical Society, the state is now suffering a critical shortage of primary care physicians." Not surprising is that expanded insurance coverage -- regardless of its noble objective -- has caused an increase in demand for medical services. But there hasn't been a corresponding increase in the number of doctors. Many Massachusetts residents now have insurance coverage but can't find a physician. The medical society also found in its 2009 survey that 56 percent of Massachusetts physicians in internal medicine aren't accepting new patients. And new patients fortunate enough to secure an appointment with a primary care doctor have an average waiting time of 44 days!
It is obvious that the U.S. physician work force and the number of medical residencies available must be increased -- and rather quickly -- in order for physicians to cope successfully with 30 million new patients. Washington has basically ignored an issue that will greatly affect patient care and that must be addressed now.
Louis J. Goodman is president and Timothy B. Norbeck is executive director of the Physicians Foundation, a Boston-based nonprofit that works with physicians to improve the health-care system.
http://www.physiciansfoundations.org/
(To its credit, Massachusetts attempted to insure all of its citizens in 2006.)
It’s the thought that counts, not reality. Typical lib-talk.
What does Mitt Romney have to say about the condition of Massachussetts health care? About what he did?
I say Romney is a coward, and worse. He will attempt to slither out of this.
It’s typical of “LIBTOPIA.” Everything is equal, everyone is kind (except them), everyone is just (except them). . . because they have a cause.
Romney’s experiment backfired.
Look for “walmart clinics” in your future, staffed with RNs and PA’s instead of doctors.
Wow, who could have seen that coming? Surely our lords and masters in D.C. Could Have anticipated that one. And as for the arguement that the SinTimes that no one could have a “moral arguement” against this law.....where to even begin.
Giving people a right to a service that has to be produced by others is that same old serpent that says you work and I eat, you toil and I will enjoy the fruits of it. Turn in whatever way you will---whether it come from the mouth of a King, an excuse for enslaving the people of his country, or from the mouth of men of one race as a reason for enslaving the men of another race, it is all the same old serpent.
I guess if slavery is no longer immoral . . . .
Think of the opportunities for the tort lawyers once people start being killed or maimed because of under-trained caregivers!
On the other hand, this could get us to actual reform of tort laws, because the problems can be blamed on Obamacare. Will we be smart enough to prepare for this dynamic?
I hope he’s sorry he never took the time necessary to understand the truth of conservatism.
Its not just drs quitting and retiring on account of this bill but there will be less money and less perks as an incentive so probably fewer students.
Of course not.
I joked with another medical info-tech professional that it wouldn't suprise me if some of the doc's in her hospital were looking at bartending in the Keys as a new career, she said such conversations are occuring....
Welcome to a brave new socialist world....
“Look for walmart clinics in your future, staffed with RNs and PAs instead of doctors.”
Quite frankly, I would not have a problem with this >>IF<< the staff at such facilities had a very serious mandate to refer any cases which exceeded their skill/competence level to a real doc. Now if you ask me how that would be achieved/enforced, I cannot answer you in detail because I don’t work in the industry. It is axiomatic that folks who don’t know, don’t know what they don’t know. But virtually all RN’s I have encountered have been pretty darn sharp.
I >>DO<< believe that something like 60-75% of doctor/emerg room visits could be handled efficiently by small, casual clinics.
If from this comment you would accuse me of acquiescing to our brave new world of healthcare, I’d have to plead guilty to some extent.
WELCOME TO CUBA!
FREE HEALTH CARE TO ALL BUT NO DOCTORS, MEDICINES, AND HOSPITALS. PLEASE WAIT INLINE.
The Dr’s will simply move to the Caribbean area and open shop on an island that is not a commonwealth of the USA.
“What does Mitt Romney have to say about the condition of Massachussetts health care? About what he did?
I say Romney is a coward, and worse. He will attempt to slither out of this.”
Romney attacks health care law similar to his own
March 28, 2010
BY GLEN JOHNSON,
Mitt Romney has a problem with Obamacare. It looks a lot like Romneycare.
The prospective Republican presidential candidate’s vulnerability on the issue was evident this week when he was interrupted during a tour for his new book by a woman upset with the Massachusetts health care law Romney signed as governor in 2006. That law has some of the same core features as the federal law President Barack Obama, a Democrat, signed Tuesday.
And that’s creating an uncomfortable straddle for Romney as his party makes attacking the new health care law its main message this midterm year.
“We are up to here with Republicans not being conservative enough,” Dr. Sharon Sikora, a Chicago dentist, said as she raised her hand over her head. “And with all due respect, governor, your health care in Massachusetts is not the be-all and end-all, and there are significant problems with that, and I wouldn’t embrace that today, either.”
Romney conceded the Massachusetts plan “isn’t perfect” and is “a work in progress,” but he put part of the blame on Democrats who overrode vetoes he believes would have improved the original plan.
And then, instead of dissociating himself from the plan as he did during his 2008 White House race, Romney complained the president didn’t tap his expertise while crafting the federal measure.
“No one came to talk to me,” Romney said. “It’s very clear that people thought they had the answer without getting the benefit of the experiment.”
Like the new federal law, the Massachusetts plan requires individuals to buy health insurance and imposes tax penalties on those who don’t. Both plans penalize small businesses above a certain size that don’t provide coverage to their employees. And both rely on new taxes for some of their financing.
“The Massachusetts plan serves as a template for federal reform,” said Richard Powers, spokesman for the state agency that sets standards for the mandatory private insurance plans individuals must buy. Obama’s plan “didn’t replicate everything that we have here, but it certainly drew from the important principles of it.”
Massachusetts has succeeded in raising the amount of insured residents to 97 percent, but the cost has strained the state treasury. Powers’ agency reported that 68 percent of the 407,000 who are newly insured got a partial or full subsidy for their coverage.
And because some of that subsidy money came from the federal government in the form of a Medicaid waiver, the state treasurer recently asked who was going to provide similar funding on the national level for Obama’s plan.
The Club for Growth, which raises campaign money for economically conservative candidates, ripped Romney this month when he declared the Massachusetts program “the ultimate conservative plan” because it requires individual responsibility. One of the group’s leaders said that if Romney believed that, “he’s in the wrong party.” Conservative columnists have been similarly critical.
The former governor dismisses his critics, saying, “You do what you think is right, and if people decide that that’s not something they’re happy with, so be it.”
Besides, he said, he hasn’t decided whether to run for president again.
Romney criticized the Obama law in a blistering posting on the conservative National Review’s Web site just hours after the House passed the bill late Sunday. But, notably, he attacked the process more than the substance.
“America has just witnessed an unconscionable abuse of power,” he wrote, complaining that Obama used extreme tactics to pass a bill without any Republican support. “For these reasons and more, the act should be repealed.”
Alternatively, he suggested starving it of money.
Romney reiterated his position after signing nearly 1,000 copies of his book at a store near his vacation home in San Diego early this week.
“I like what we have in Massachusetts, despite some flaws,” Romney said. “But what I see in Obamacare is a very different piece of legislation - and one that followed a very different track. In our case, our bill was carried out in a bipartisan basis.”
Political analysts expect his rivals to gloss over such distinctions - and attack the general similarities - in any future campaign.
“He’s explaining the differences between Massachusetts and Washington in some very subtle and complex ways, and politics is about simple truths - particularly in party primaries,” said Jeffrey Berry, a political science professor at Tufts University in Massachusetts.
Berry noted both laws require that people get insurance coverage, and both impose new taxes and penalties - “anathema to mainstream Republicanism. And both involve a significant expansion of government. So, on all those counts, Mitt Romney is vulnerable.”
http://www.southtownstar.com/news/2124951,032810romney.article
Tha’ts fine for minor matters, but major matters could be easily misdiagnosed.
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