From: Orlando, Florida
Registered: Oct 2001
|Mass. Medical Plan Foretells Obamacare’s Ills|
Five years ago, Massachusetts’ then-Gov. Mitt Romney approved a new medical plan that requires almost all state residents to have health insurance, just as Obamacare’s individual mandate would for the entire nation.
Today in Massachusetts, the wait time to see a doctor can be as long as seven weeks, and many doctors won’t accept patients in the subsidized insurance program. That does not bode well for national healthcare reform if it is fully implemented as planned by President Barack Obama and the Democrats.
A new study by the Massachusetts Medical Society (MMS), which has 23,000 physicians and student members and publishes the prestigious New England Journal of Medicine, takes an in-depth look at healthcare in Massachusetts under the state program, which is often regarded as a model for Obama’s 2010 healthcare reforms. Among its findings:
• The average wait time for an appointment with an internist is 48 days, and the wait time to see a family physician is 36 days.
• The average wait time for pediatricians is 24 days, according to the MMS’s “2011 Study of Patient Access to Health Care.”
• Access to primary care physicians is becoming more restricted — 53 percent of family physicians and 51 percent of internists are not accepting new patients.
• Patients wait an average of 43 days to see a gastroenterologist, and 41 days to see an obstetrician/gynecologist.
• While 87 percent of family physicians accept Medicare, only 62 percent accept MassHealth, the state’s version of Medicaid.
• Only 56 percent of family physicians and 43 percent of internists accept Commonwealth Care, an insurance program for adults who don’t have private health insurance and don’t qualify for Medicare. Just 44 percent of family physicians and 35 percent of internists accept Commonwealth Choice, a program for uninsured adults that offers unsubsidized health insurance to people who are not eligible for Medicaid or Commonwealth Care.
• Due, in part, to a shortage of doctors participating in the program, the number of emergency room visits has actually risen under the Massachusetts plan.
“Massachusetts has made great strides in securing insurance coverage for its citizens, but insurance coverage doesn’t equal access to care,” said Alice Coombs, M.D., president of the MMS. “We still have much work to do to reduce wait times and widen access. This has important implications for healthcare cost control, as difficulty or delay with routine access to care leads people to seek other options, such as the emergency room, which is much more costly.”
|Obamacare Spurs Doctor Shortage Crisis|
The healthcare reform bill enacted last year will significantly increase the number of Americans with health insurance and exacerbate an already looming doctor shortage.
The Association of American Medical Colleges reported in 2010 that the United States will need an additional 130,000 doctors — general-practice physicians and specialists — in 15 years, 20 percent more doctors than are currently practicing. But medical school enrollment has been essentially flat, and about a third of American physicians are over the age of 55 and likely to retire by 2020.
Making matters worse, Congress in 1996 capped the number of new doctors Medicare would pay to train. And President Barack Obama’s National Commission on Fiscal Responsibility and Reform proposed cutting Medicare funding for training even further, by $60 billion through 2020. “If this cut is enacted, the doctor shortage would get far worse,” The Wall Street Journal reported.
At the same time, the number of patients is certain to increase. Baby boomers will be retiring at the rate of 10,000 per day, and they will require more medical care as they age. Plus, Obamacare will boost the number of Americans with health insurance or participating in Medicaid, which will mean greater demand for doctors’ services.
At present, physicians are reimbursed at roughly 78 percent of costs under Medicare, and just 70 percent under Medicaid, according to Michael Tanner, a Cato Institute senior fellow.
As a result, more and more physicians are choosing to opt out of the government programs altogether. Already, as many as a third of doctors will not participate in Medicaid, and 13 percent won’t accept Medicare patients.
With cuts in reimbursements on the horizon with Obamacare, “retirement in Florida may begin to look like a very good option” for many older doctors, observes Tanner, whose article appeared in the New York Post. “Are they really going to want to stick it out for a few more years if all they have to look forward to is more red tape for less money?”
A 2010 poll by IBD/TPP found that 45 percent of physicians would at least consider leaving their practice or taking early retirement as a result of Obamacare.
These various factors will combine to produce a shortfall of more than 150,000 doctors over the next 15 years, according to the Association of American Medical Colleges.
As a start in dealing with the problem, the Obama commission’s recommended cuts in training funds should be set aside, Dr. Herbert Pardes, president and CEO of New York-Presbyterian Hospital, writes in the Journal. “Secondly, the cap enacted in 1996 on training new doctors should finally be lifted. These two steps would go a long way to addressing our country’s medical needs.”
Tanner concludes, “Promising universal health coverage is easy. But what does universal coverage mean if you can’t actually see a doctor?”