Wintery Knight

…integrating Christian faith and knowledge in the public square

Doctor shortage: how Obamacare makes it harder to find a doctor

Remember how Obama promised that if you liked your doctor, then you could keep your doctor? It turns out that there is more to making policies than just saying what you’d like to do in a scripted campaign speech. The truth is that some health care policies will make you lose your doctor, regardless of what the President reads off of a teleprompter. Is Obamacare one of these policies? Let’s see.

Avik Roy writes about it in Forbes magazine.

Excerpt:

On Saturday, the Wall Street Journal reported that, due to Obamacare’s cuts to Medicare Advantage, among other factors, UnitedHealth expects its network of physicians “to be 85 percent to 90 percent of its current size by the end of 2014.” The result? Some retirees enrolled in Medicare Advantage will need to find new doctors. And it’s a trend that could accelerate in future years.

[…]Over the next ten years, Obamacare was designed to spend around $1.9 trillion on expanding health coverage to the uninsured. The law pays for this new spending with $1.2 trillion in new taxes, and $716 billion in cuts to Medicare, relative to prior law.

[…]The private insurers who supply Medicare Advantage plans, like UnitedHealth and Humana, have been responding to the cuts by squeezing out inefficiencies in the way they deliver care. One obvious way to do that is to pay doctors and hospitals less—or kick out the providers who refuse to accept lower reimbursement rates. And that’s what United has done, according to the WSJ report from Melinda Beck.

“Doctors in at least 10 states have received termination letters, some citing ‘significant changes and pressures in the health-care environment,’” writes Beck.

Another one of my favorite health care policy experts is the ex-Canadian Sally C. Pipes, who knows all about the horrors of single-payer health care. It killed her mother! Here’s what she had to say about the doctors shortage in a Forbes magazine article from earlier this year.

The first problem is that we have an aging doctor population and since we do such a poor job of educating our children (public school indoctrination centers) we aren’t making any new ones:

Right now, the United States is short some 20,000 doctors, according to the Association of American Medical Colleges. The shortage could quintuple over the next decade, thanks to the aging of the American population — and the aging and consequent retirement of many physicians. Nearly half of the 800,000-plus doctors in the United States are over the age of 50.

The second problem is that adding more regulations and burdensome paperwork makes a lot of people not want to be doctors any more:

Obamacare is further thinning the doctor corps. A Physicians Foundation survey of 13,000 doctors found that 60 percent of doctors would retire today if they could, up from 45 percent before the law passed.

The third problem is that the government isn’t reimbursing doctors as much as private insurance companies do, and it makes them refuse to take government-funded patients:

They’ve long limited the number of Medicaid patients they’ll treat, thanks to the program’s low reimbursement rates. According to a study published in Health Affairs, only 69 percent of doctors accepted new Medicaid patients in 2011. In Florida, just 59 percent do so. And a survey by the Texas Medical Association of doctors in the Lone Star State found that 68 percent either limit or refuse to take new Medicaid patients.

Medicaid pays about 60 percent as much as private insurance. For many doctors, the costs of treating someone on Medicaid are higher than what the government will pay them.

These underpayments have grown worse over time, as cash-strapped states have tried to rein in spending on Medicaid. Ohio hasn’t increased payments to doctors in three years; Kentucky hasn’t raised them in two decades. Colorado, Nebraska, South Carolina, Arizona, Oregon, and Arizona all cut payments in 2011.

By throwing nine million more people into the program without fixing this fatal flaw, Obamacare will make it even harder for Medicaid patients to find doctors.

It’s not just Medicaid that’s the problem, either. It’s the government-controlled exchanges.

Healthcare providers are signaling that they may turn away patients who purchase insurance through the exchanges, too.

In California, for example, folks covered by Blue Shield’s exchange plan will have access to about a third of its physician network. The UCLA Medical Center and its doctors are available to customers of just one plan for sale through the state exchange, Covered California. And the prestigious Cedars-Sinai Medical Center is not taking anyone with exchange insurance.

Now I know what you’re thinking – why not just force doctors to work for lower wages, like a good socialist country might? Well, that actually makes the shortage worse, because people don’t like to learn hard things and then work hard for little pay. And doctors work VERY hard – it’s not an easy profession to get into. That will just make all the doctors leave the country for other countries where they can be paid fairly for the work they do.

And in fact that is exactly what happened in a 100% socialized health care system in Venezuela, according to this report from the left-leaning Associated Press.

Excerpt:

Half the public health system’s doctors quit under Chavez, and half of those moved abroad, Natera said.

Now, support staff is leaving, too, victim of a wage crunch as wages across the economy fail to keep up with inflation.

At the Caracas blood bank, Lopez said 62 nurses have quit so far this year along with half the lab staff. It now can take donations only on weekday mornings.

I recommend reading that entire article for a glimpse of where the Democrats are trying to take us. There is not a dime’s worth of difference on policy between the Democrat party and the socialist party of Venezuela, except that the socialists have been in control in Venezuela for longer, and so they are further along the road to serfdom.

In other news, the Washington D.C. insurance commissioner was fired after raising concerns about the “fix” proposed by Obama in his speech last week. That’s also something that you might expect to see in a country like Venezuela. That’s what happens in authoritarian socialist countries. Whistleblowers and critics just disappear.

Filed under: News, , , , , , , , , , , , , , , , , , , , , , , , ,

Fact check of Obama’s budget: is there really $4 trillion in deficit reduction?

Here’s a story from the House Budget Committee, where Paul Ryan is the leader.

Paul Ryan made these two charts to help him discuss Obama’s new budget with Obama’s budget director.

Debt Increase in President's Budget
Debt Increase in President’s Budget

And:

Actual savings is 410 billion, not 4 trillion
Actual savings is 410 billion, not 4 trillion

Watch these clips to see Paul Ryan and Scott Garrett use the charts to do nasty things to Obama’s budget director.

Clip 1 of 3:

Clip 2 of 3:

Clip 3 of 3:

Guy Benson discusses both videos at Townhall.com.

Excerpt:

Ryan does a masterful job of puncturing Zients’ arguments, but let’s reiterate a few points that may have gotten lost in the shuffle.

(1) The White House is claiming that spending cuts within the Budget Control Act of 2011 — which is entirely separate from the FY 2013 budget — should count as savings “achieved” by their new proposal.  This is silly on its face, but crosses into laughable territory when one recalls that throughout much of the debt fight, President Obama adamantly opposed a cuts-for-debt-ceiling-hike quid pro quo.  He was on the record in favor of — demanding, in fact — zero cuts. Republicans dragged him into the BCA against his will; now he’s trying to take credit for that past action in next year’s budget.

(2) The White House says Obama’s budget “saves” $850 Billion by not fighting two wars at peak spending levels for another full decade.  This money was never proposed because the scenario is pure fiction.  These risible “savings” represent a White House bear-hug of Moon-Yogurt accounting. “Heaven help us” is right.

(3) Zients’ isn’t able to recall how much money this budget adds to the national debt.  You’d think the White House Budget Director would have that figure committed to memory (he likely does, but doesn’t want to admit it on camera), but let’s help him out:  The budget he’s defending adds nearly $11 Trillion to the debt, on top of the roughly $5 Trillion increase over which this president has already presided.  I seem to recall an infamous Right-wing zealot calling this sort of governance “unpatriotic.”

Next, we have Rep. Scott Garrett, a strong conservative from Northern New Jersey, asking Zients when the president’s budget comes into balance.  Zients refuses to directly respond to the question, perhaps because the correct answer is “never”…

Indeed, the closest Obama’s budget ever comes to balancing (expenses = revenues) within the ten-year projection window is 2017’s annual deficit of $617 Billion, which is still more than double the size of President Bush’s average annual deficit. Finally, Garrett lures Zients into a trap over Obamacare.  Garrett asks if a family making less than $250,000 per year (“the rich” cut off) is subject to a tax increase if they fail to comply with Obamacare’s individual mandate…

The president sold Obamacare to the public by characterizing the resulting mandatory pay-out as a “fine,” not a tax increase.  He even mocked George Stephanopoulos’ suggestion that it met the dictionary definition of a tax hike.  Once the law passed, however, the administration’s lawyers pulled an about-face and have defended the mandate in court by arguing that the fine is, in fact, a tax increase after all.  Zients has apparently reverted back to the outmoded argument, thus undermining his own administration’s legal defense of their signature “accomplishment.”

What I find frustrating is the media does such a poor job of vetting these “4 trillion dollar” claims that Obama makes. Sometimes, I wonder why anyone listens to mainstream media at all. What do you really learn?

Filed under: News, , , , , , , , , , , , , , , , , , , , ,

MUST-READ: How Obama reduces the supply of medical care

I had written about the so-called doc-fix before, which is the problem of doctors being underpaid by the government for things like Medicare and Medicaid when they provide services to patients. Obama chose not to “fix” these low reimbursements in his health care bill, in order to hide the true costs of socializing medicine. But he has a plan now to fix the problem of government-run medicine not reimbursing doctors adequately.

And it isn’t what you might think.

From Laura at Pursuing Holiness. (H/T ECM)

Excerpt:

Conservatives were outraged by the chicanery of separating physician payment increases from the health care reform (that’s three lies for the price of one) bill Congress recently rammed through.  The “doc fix” was separate legislation so that physician payments could be increased without adding to the total cost of the main bill, so that Democrats could dishonestly claim the bill reduced the deficit.  Now, however, we are seeing the real “doc fix.”

Some Idaho orthopedists grew weary of the low reimbursement rates the government gave them for caring for worker’s comp patients.  So they got together and agreed not to treat those patients anymore.  They hoped that their boycott would force the Idaho Industrial Commission to increase the fee schedule – their payments.  While they were at it, they decided to stop working with Blue Cross of Idaho – also a notorious underpayer – until a better deal could be negotiated.  Unions behave this way all the time, and it’s often very effective.

In a similar case in Colorado last February, the Federal Trade Commission stepped in and charged the doctors with price-fixing.

Those doctors lost, and if they want to continue to work as physicians, they will do so at the prices set by the government.

Now the Obama administration has stepped it up a notch. The FTC only deals with civil complaints. In order to deal with the Idaho orthopedists, Obama sent in Eric Holder and the Justice Department, which is at liberty to file criminal charges.  You see, those Idaho orthopedists collectively agreeing that they had enough and weren’t going to take it anymore, were actually engaged in two antitrust conspiracies.

Read the rest. This is another first class post by Laura, and a great find by ECM. (Laura also sides with me on women taking responsibility for their own actions, which is why men like her)

So, it sounds like the Obama administration is heading towards Canada’s system where the private practice of medicine is a criminal offense. Doctors will not be able to set prices for their services. A patient giving money directly to a doctor, without government approval of the price (price controls), will become illegal. That’s the way that socialists roll.They love to fix prices.

And do you know what happens when doctors make less money than government clerks but have to work 80 hour weeks? That’s right – you have a shortage of doctors! Just like in Canada! And do you know what happens when there is a shortage of doctors? That’s right – you pay for the privilege of dying on a waiting list. (Unless you want an abortion, IVF or a sex change, I guess – because that’s politically correct in Canada)

This is why there are waiting lists in every country that has tried socialized medicine. Fewer doctors means fewer claims to the government – rationing. It’s the real way that government cuts costs. Well, that and euthanasia. Once government starts to regulate the practice of medicine, and to fix prices, you choke off the supply. And then you have to start killing people to avoid bankrupting the system, without or without their consent.

Filed under: News, , , , , , , , , , , , , , , , , , , , ,

Wintery Tweets

RSS Intelligent Design podcast

  • An error has occurred; the feed is probably down. Try again later.

RSS Evolution News

  • An error has occurred; the feed is probably down. Try again later.
Click to see recent visitors

  Visitors Online Now

Page views since 1/30/09

  • 4,689,910 hits

Enter your email address to follow this blog and receive notifications of new posts by email.

Join 2,275 other followers

Archives

Follow

Get every new post delivered to your Inbox.

Join 2,275 other followers

%d bloggers like this: