Posted on 01/07/2012 5:34:10 AM PST by Kaslin
Are you having difficulty finding a doctor who will see you? If you are, brace yourself. Things are about to get a whole lot worse.
Right now, the biggest problems are in Massachusetts. If you live in Boston and are trying to see a new family doctor, get prepared to wait more than two months before you ever get a foot in the door. For the state as a whole, the average wait to see a new family doctor is one month. More than half of all family doctors and more than half of all internists are not accepting new patients at all.
What if you live in another state? Just wait two more years. In Massachusetts people are lined up waiting to see doctors because of the health reform championed by the former governor (RomneyCare). And as Barack Obama has said on more than one occasion, RomneyCare is the model for ObamaCare.
Why? In both the Massachusetts health plan and the new health care law the mistake is the same: insuring the uninsured, but doing nothing to enable the medical community to deliver more care. Massachusetts succeeded in cutting the number of uninsured in half — a worthy accomplishment. But the state did nothing to expand the number of doctors, nurses or paramedical personnel. The result: a major increase in the demand for care, but no change in supply.
I learned what this means in human terms a while back from a Boston cab driver. She was on MassHealth (Medicaid) and her biggest problem, she told me, was getting care. "I went down a list of 20 doctors before I found one who would see me," she said. "Twenty doctors?" I responded incredulously. "Were you going through the Yellow Pages?" "No," she said, "I was going down the list MassHealth gave me."
In Massachusetts, this is what the advocates of health reform call "universal coverage."
Bad as all this is, it is actually rather mild compared to what is about to happen in other states. In Massachusetts, less than 10 percent of the population was uninsured before the reform set in. In Texas, by contrast, one in every four people is currently uninsured. Insure half of those and the demand for Texas doctors is going to soar.
Estimates are that ObamaCare will succeed in insuring 32 million otherwise uninsured people. If economic studies are correct, once these folks are insured, they will try to double their consumption of health care. On top of that, ObamaCare does something that Massachusetts did not do. It will force the vast majority of people who already have insurance to switch to more generous coverage. For example, everyone will have to be covered for a long list of preventive care and diagnostic screenings, with no copay and no deductible. Once people have this extra coverage, they will be inclined to take advantage of it.
Get prepared, then, for a huge increase in the demand for care. The result will be growing waiting lines — at the doctors’ offices, at hospital emergency rooms, at the health clinics, etc.
In the early stages of Massachusetts' health reform, Governor Romney told me what he expected to happen. Instead of uninsured patients going to hospital emergency rooms to get expensive care in inappropriate settings (all paid for by the rest of us), he said, insured patients will be getting less expensive care in the offices of primary care doctors.
Ah, but the best laid plans …. Turns out that more people are currently seeking care in hospital emergency rooms and at publicly funded community health centers than there were before the reform! As one academic study concluded, in Massachusetts you have the same people seeking the same care at the same places you had before. Health reform has mainly meant shuffling money around from one bureaucracy to another.
When health care is rationed by waiting, who gets care and who doesn’t? Here is the real surprise. Just as ObamaCare intends to do, Massachusetts set up health insurance exchanges where the uninsured could obtain insurance, in most cases with generous government subsidies. Yet the newly insured are the patients having the greatest difficulty obtaining access to care. According to one report:
• Only 56 percent of family doctors accept patients enrolled in Commonwealth Care (subsidized insurance sold in the "exchange").
• Only 44 percent accept patients in Commonwealth Choice (unsubsidized insurance sold in the "exchange").
• The fraction of internists who accept Commonwealth Care and Commonwealth Choice is 43 percent and 35 percent, respectively.
In Massachusetts this is called "access to care."
ping
How can a working person be eligible for Medicaid? Isn't that for people on welfare?
Our GP is probably way overbooked and typically sees us at least a half hour after our scheduled appointment. Urgent Care will typically see us in less time on a walk-in basis, and can do more during the visit than the GP can. It costs extra, but it’s worth the money to get more service. In fact, on more than one occasion our GP recommended going to urgent care when he was booked up.
The last time we went to the ER, I had the feeling that because we have insurance, we moved way up in line. We still sat in the “curtained room” for a long time but we weren’t in Little Tijuana (waiting room) long at all.
We have a couple nearby. They’re very nice and the wait is minimal. If you need an xray or something, they send you to the hospital and you get taken care of right away. MUCH better than the hospital emergency room system where you can wait hours....
“you’ll need to pay under the table bribes to get seen”
****
When Hillarycare was being bandied about circa 1993, one of the popular alternatives being considered was private pay hospital ships. Take a medical-related cruise out into international waters. Look for that to happen if Obamacare is fully implemented.
In SW Florida most physicians are going to a conceirge service. They won’t take medicare, medicaid or insurance. To keep our long time family physician we have to pay a $2,000/year upfront fee to remain his patients.
Then again, in the last few years when you walk into his waiting room his “new” clients all spoke Spanish and came in as a “family unit” for him to cure everyone from Grandma down to the baby in the womb.
Obamacare is going to have the tail wagging the dog. Nobody is going to get good care. All of this for folks on the dole.
To get in front of the line just wear a green baseball hat that says BORDER PATROL.
To get in front of the line just wear a green baseball hat that says BORDER PATROL./s
One ER stay, I peeped out the curtain and say the doctor sitting in a chair, drumming his fingers on the table. Then he left. Then he came back. I was just sitting there. This stay was 4 hours. Nothing was done to me in those 4 hours.
Except the money clock ticking. Are patients charged for the room in the ER by the hour? Does anyone know?
I SAW the doctor, not ‘say’ the doctor. Sorry ‘bout that.
IF you had blood work or other tests done the doctor would have had to wait for them to be done and the results given to him.
That's been my prediction this time around--medical care outside the 12-mile limit; just like they do with gambling on cruise ships.
The medical care and insurance system in the US is uniquely perverse. If you are over 65, you can't buy any insurance other than supplemental insurance. You could walk in and private pay, but then you'd get completely screwed because you'd pay exorbitant prices (think the proverbial 50 dollar aspirin). You MUST be in some sort of buying club to get charged the effective (and known) price for care.
One problem is that there is no acknowledgement of limits in care--rationing is done under the table in weird ways, like the difficulty in finding a primary care physician. If you give up looking (or your doctor is far too busy to see you for other than well visits) and go to the emergency room, you'll pay a huge copay, while the illegal next to you goes for free.
A long time ago, Ludwig von Mises said that the weakness of socialism in comparison to capitalism was that it lacked an effective resource allocation system because the command economy didn't allow bottoms up discovery of need through market price discovery. That's precisely the situation we have now in the US in the medical area. No one knows what any procedure will cost. If you ask your doctor, he'll quote you some list price which he never expects to be paid. It's the same with hospitals, drugs, and supplies.
“The medical care and insurance system in the US is uniquely perverse. If you are over 65, you can’t buy any insurance other than supplemental insurance. You could walk in and private pay, but then you’d get completely screwed because you’d pay exorbitant prices (think the proverbial 50 dollar aspirin). You MUST be in some sort of buying club to get charged the effective (and known) price for care.”
Here’s another profound perversity demonstrating the failure of the Feds to respect individual rights...
http://thefundforpersonalliberty.org/medicare-lawsuit-update/index.html
yes
Same here in Raleigh.
My Dr moved. I’ve not been able to find a replacement.
As soon as I mention Medicare they say sorry.
Warning, anyone nearing retirement age, find a Dr or stick with the one you have.
“You could walk in and private pay, but then you’d get completely screwed because you’d pay exorbitant prices (think the proverbial 50 dollar aspirin).”
It’s my understanding that it is just the opposite. Doctors do NOT want all the insurance hassle. I remember Rush up-front paying for his hospital stay a few years back and it was MUCH cheaper than through insurance. I’ve read about this frequently, which is why alot of doctors are going the “concierge” route. Yes? No?
http://thefundforpersonalliberty.org/medicare-lawsuit-update/index.html
The implications of this decision are very bad. However, I'd also feel more sympathetic to these particular plaintiffs if they weren't trying to escape Medicare to continue receiving enhanced taxpayer-funded government medical insurance that is better than that the rest of us are forced onto.
While the judge is IMHO wrong that you MUST accept Medicare or forego your SS pension benefits, it would also be wrong for all government workers to be able to jump from the Medicare system to enhanced lifetime medical benefits through a judicial decision.
If I recall correctly, I recently saw an article about hospitals in Greece requiring women in labor to pay upfront to have their babies in the hospital. No more charity cases there.
thank God i have a great primary care Doc and that he is 15 years younger than me so he won't retire before i die... but there have been 3 times i couldn't see him for at least six months, once because he was in Iraq and twice because he was in Afghanistan...
he's a Major in the Army Reserve
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