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, , , , , , , , , , , , , , , , , , , , , , , , ,

Duke U. researcher: 129 million people will lose health insurance under Obamacare

From the Daily Caller.

Excerpt:

If Obamacare is fully implemented, 68 percent of Americans with private health insurance will not be able to keep their plan, according to health care economist Christopher Conover.

Conover is a research scholar in the Center for Health Policy & Inequalities Research at Duke University and an adjunct scholar at the American Enterprise Institute. In an interview with The Daily Caller, he laid out what he estimates the consequences of Obamacare’s implementation will ultimately be.

“Bottom line: of the 189 million Americans with private health insurance coverage, I estimate that if Obamacare is fully implemented, at least 129 million (68 percent) will not be able to keep their previous health care plan either because they already have lost or will lose that coverage by the end of 2014,” he said in an email. ”But of these, ‘only’ the 18 to 50 million will literally lose coverage, i.e., have their plans entirely taken away. This includes 9.2-15.4 million in the non-group market and 9-35 million in the employer-based market. The rest will retain their old plans but have to pay higher rates for Obamacare-mandated bells and whistles.”

Conover also says it is hard to imagine President Obama didn’t know these statistics when he was flacking for his health care bill by promising Americans they could keep their health insurance if they liked it.

“If President Obama himself believed this the first time he said it, he was poorly advised,” Conover said.

“The problem is that he said it at least 24 times, most of which occurred after his own rule-writers had estimated that 49-80 percent of small employer plans would have lost their grandfather status by 2013, along with 34-64 percent of large employer plans. The same rule estimated that each year 40 to 67 percent of non-group plans not already grandfathered would lose their grandfather status. Given how extensively presidential statements — especially to a joint session of Congress — are vetted and fact-checked, it is pretty inconceivable that President Obama was not aware that he was engaged in some degree of truth-twisting.”

Surprise! It looks like what the Democrats wanted was to destroy private health insurance, after all. The nice thing about this is that finally the low-information voters who elected Obama are getting to see why it might be a good idea to get their political news from somewhere other than the Comedy Channel.

Filed under: News, , , , , , ,

Doctor shortage: how Obamacare makes Americans lose their doctors

Mysterious Tim sent me this article from the Wall Street Journal.

Excerpt:

Everyone now is clamoring about Affordable Care Act winners and losers. I am one of the losers.

My grievance is not political; all my energies are directed to enjoying life and staying alive, and I have no time for politics. For almost seven years I have fought and survived stage-4 gallbladder cancer, with a five-year survival rate of less than 2% after diagnosis. I am a determined fighter and extremely lucky. But this luck may have just run out: My affordable, lifesaving medical insurance policy has been canceled effective Dec. 31.

My choice is to get coverage through the government health exchange and lose access to my cancer doctors, or pay much more for insurance outside the exchange (the quotes average 40% to 50% more) for the privilege of starting over with an unfamiliar insurance company and impaired benefits.

Countless hours searching for non-exchange plans have uncovered nothing that compares well with my existing coverage. But the greatest source of frustration is Covered California, the state’s Affordable Care Act health-insurance exchange and, by some reports, one of the best such exchanges in the country. After four weeks of researching plans on the website, talking directly to government exchange counselors, insurance companies and medical providers, my insurance broker and I are as confused as ever. Time is running out and we still don’t have a clue how to best proceed.

Here previous private health insurance plan was doing a good job of honoring her policy:

Since March 2007 United Healthcare has paid $1.2 million to help keep me alive, and it has never once questioned any treatment or procedure recommended by my medical team. The company pays a fair price to the doctors and hospitals, on time, and is responsive to the emergency treatment requirements of late-stage cancer. Its caring people in the claims office have been readily available to talk to me and my providers.

I think that this is what Obama was talking about when he cautioned people about insurance companies that “screw you”. Yeah, private companies always screw people, Obama, never the government. What does this man know about how anything actually works in the real world, anyway?

More:

What happened to the president’s promise, “You can keep your health plan”? Or to the promise that “You can keep your doctor”? Thanks to the law, I have been forced to give up a world-class health plan. The exchange would force me to give up a world-class physician.

For a cancer patient, medical coverage is a matter of life and death. Take away people’s ability to control their medical-coverage choices and they may die. I guess that’s a highly effective way to control medical costs. Perhaps that’s the point.

Another factor that is going to make this situation worse is the widespread decline in the number of doctors caused by Obamacare.

Investors Business Daily reports on a recent poll of doctors by Deloitte.

Excerpt:

When our polling showed four years ago that doctors planned to leave the profession if the Democrats’ interpretation of health care reform became law, we were ridiculed mercilessly. But, as a new poll shows, we were right.

In 2009, our IBD/TIPP Poll asked 1,376 randomly chosen practicing physicians from across the country what they thought about the health care “reform” being considered at that time.

It found that 45% of doctors “would consider leaving their practice or taking an early retirement” if Congress passed the plan the White House and the Democratic majority in Congress had in mind.

[...]But almost a year later, we were vindicated. An August 2010 Merritt Hawkins survey of 2,379 doctors conducted for the Physicians Foundation revealed that 40% of doctors said they would “retire, seek a nonclinical job in health care, or seek a job or business unrelated to health care” over the next three years as the overhaul was phased in.

Those three years are up, the country has found out what’s in ObamaCare, and the story remains the same.

The Deloitte 2013 Survey of U.S. Physicians found that six in 10 doctors say “it is likely that many physicians will retire earlier than planned in the next one to three years” — that is, in the age of ObamaCare — “while more than half believe that physicians will retire (62%) or scale back practice hours (55%) based on how the future of medicine is changing.”

The problem is that when government controls health care, they spend the money on things that will buy them more votes. People who need expensive care like this definitely do not get treated. In government-run health care, government takes control of the money being spent by individuals on actual health care in the private sector. They then redirect that money into public sector spending on “health-related” services. Instead of helping people who are really sick, government-run systems cut lose those sick people and concentrate on buying perfectly healthy people things like condoms, abortions, IVF and sex changes. They spread the money around to more people in order to buy more votes. The main goal is to get the majority of people dependent on government so that they continue to vote for bigger government. The few people who need expensive health care? They can just go die in a ditch.

The really sick thing is when a person works their entire lives, paying into a government-run health care system, and then when it is their turn at the end to finally get some treatment, they find out that they are denied treatment, and their money has all been spent on elective treatments for favored (liberal) minority groups. I’m sorry, but you can’t have treatment for prostate cancer, because we used the money we got from you to provide IVF to a professor of women’s studies who spent her fertile years advocating for abortion and against marriage. We should never be letting government control health care. Never.

Filed under: Commentary, , , , , , ,

Sally Pipes: how Obamacare causes doctors to quit practicing medicine

Sally C. Pipes is one of my favorite health care policy analysts. She has written several books on topics like the Canadian health care system, the American health care system, and the Obamacare health care law. She has debated health care with that damnable leftist Paul Krugman, among others. She heads up a think tank based in San Francisco, CA called the Pacific Research Institute.

Here is her latest column in the Orange County Register.

Excerpt:

Thanks to Obamacare, America’s corps of doctors appears to have a case of the blues.

The Physicians Foundation recently asked more than 13,000 doctors about their morale, their career plans, their practices and their views of the Affordable Care Act. The results were grim.

Nearly six in 10 doctors said that they are less positive about the future of health care in America under Obamacare. Almost two-thirds have a negative attitude toward their jobs – nearly twice as many as before the health law was passed in 2010.

As a result, many doctors are cutting back on their workload or shuttering their practices. Worse, their collective frustration is exacerbating our nation’s troubling doctor shortage.

More than three-fifths of doctors say they would retire today if they could, compared with 45 percent before Obamacare. Eighty-four percent say the medical profession is in decline. Fewer doctors say they would enter the profession today if they had it to do over again, and fewer would recommend it to their children.

This decline in doctors’ morale is taking a toll on Americans’ ability to access care. Physicians report working almost 6 percent fewer hours than they did four years ago. That’s about two and a half hours less per week per doctor. Add up all the hours, and it’s the equivalent of losing more than 44,000 full-time physicians.

Doctors also report seeing some 16 percent fewer patients than they did in 2008. That represents tens of millions fewer doctor-patient encounters each year.

More than half those surveyed say they plan to cut back further on the time they devote to patient care, to work part time, to retire or to switch to direct-pay “concierge”-type medical practices, which are beyond the reach of many of Obamacare’s rules and regulations.

Even before the law, America faced a chronic doctor shortage, with a gap of 14,000 physicians in 2010. And the problem will only grow worse.

According to the Association of American Medical Colleges, Obamacare will push the doctor shortage up to 63,000 by 2015 – and more than 91,000 by 2020. That’s in addition to the full-time-equivalent losses from doctors working fewer hours.

I have been talking to people in my office who voted for Obama all week to see why they did what they did. Surprisingly, not many people I talked to voted for him. But for those that did, a popular reason is that they wanted to tax the rich more. I asked them what would happen if you taxed the rich more. They told me that Obama can tax people who are “rich” more and more and that the “rich” will just keep paying those higher taxes while still continuing to work and work to provide the goods and services that we all use. I asked them about regulations, and they said that Obama can just keep heaping burdensome regulations on these “rich” people more and more, and they won’t mind at all. They’ll just keep working and hiring people and providing goods and services even if they make less money and have to work more to comply with regulations.

One of the Indian contractors who voted for Obama told me that rich people do what they do because they like it, and they will keep doing it no matter how much we tax and regulate them. “They will do it for love of fairness, and because Obama is such a good man – they will be inspired by him to pay the higher taxes and to fill in the extra paperwork”, he told me. For him, people just do whatever they like. The reason why some people work is because they like working, and the reason why some people don’t work is because they like not working. Another Obama-voter told me that people should be able to do whatever they like and everyone should end up equal in the end. Some people will work because they like to, and others won’t. Taxes don’t affect what a person does. Nor does the difficulty of the work. Nor does the exposure to malpractice lawsuits.  Nor does the higher medical insurance premiums. Doctors do what they do because they like it, and the conditions and profit margins don’t matter. Rich people like doctors will keep working at whatever they do even if they are taxed so much that they earn the same amount of money as people who work at McDonald’s.

That’s the worldview of the people who voted for Obama. They don’t understand incentives at all. They don’t understand the profit motive. They think that people who go to medical school until they are 35, racking up tens of thousands of dollars in debt in the process, will be happy to work 80 hour weeks and to pay 50% of their income in taxes so that other people can have free contraceptives. That is the worldview of the left – they have no idea what the consequences are of raising taxes on “the rich”. They don’t think that there are any consequences.

If you would like to see Sally Pipes talk a bit more about Obamacare, you can watch her explain it here:

Eight minutes long.

Filed under: Commentary, , , , , , , , , , , , , , ,

California: Obamacare exchanges will raise health insurance premiums up to 25%

The radically leftist Los Angeles Times reports on it. (H/T The Cato Institute)

Excerpt:

California’s health insurance exchange said more than 30 plans are expected to vie with one another for spots in the state-run marketplace opening next fall.

State officials, and those in other states, are eager to flex their purchasing power under the federal healthcare law by selecting only certain individual and small-business health plans for 19 different regions across California.

The exchange, branded Tuesday as Covered California, will negotiate with insurers for the best rates and will assist consumers and small businesses in choosing a plan by separating them into five categories based on cost and level of benefits.

[...]The ability of the exchange to lower healthcare costs remains unclear. Experts said average premiums could rise in the exchange because the Affordable Care Act requires improved benefits, but consumers’ out-of-pocket medical costs could decrease under those same changes.

California insurance officials have expressed concern about substantial rate hikes for some existing policyholders going into the exchange.

Under a new rating map approved by state lawmakers, the Department of lnsurance estimated that premiums for similar coverage could increase as much as 25% in West Los Angeles, 22% in the Sacramento area and nearly 13% in Orange County.

Do you want to pay higher medical insurance premiums? Can you afford it? We’ve already seen massive drops in average household incomes under this President.

According to Forbes magazine:

New income data from the Census Bureau reveal what a great job Barack Obama has done for the middle class as President. During his entire tenure in the oval office, median household income has declined by 7.3%.

In January, 2009, the month he entered office, median household income was $54,983. By June, 2012, it had spiraled down to $50,964. That’s a loss of $4,019 per family, the equivalent of losing a little less than one month’s income a year, every year. And on our current course that is only going to get worse not better…

[...]Three years into the Obama recovery, median family income had declined nearly 5% by June, 2012 as compared to June, 2009. That is nearly twice the decline of 2.6% that occurred during the recession from December, 2007 until June, 2009. As the Wall Street Journal summarized in its August 25-26 weekend edition, “For household income, in other words, the Obama recovery has been worse than the Bush recession.”

[...]Obama has failed the poor as well as the middle class. Last year, the Census Bureau reported more Americans in poverty than ever before in the more than 50 years that Census has been tracking poverty. Now The Huffington Post reports that the poverty rate is on track to rise to the highest level since 1965, before the War on Poverty began. A July 22 story by Hope Yen reports that when the new poverty rates are released in September, “even a 0.1 percentage point increase would put poverty at the highest level since 1965.”

Additionally, medical insurance premiums, which Obama promised to lower, are actually up.

From Investors Business Daily.

Excerpt:

During his first run for president, Barack Obama made one very specific promise to voters: He would cut health insurance premiums for families by $2,500, and do so in his first term.

But it turns out that family premiums have increased by more than $3,000 since Obama’s vow, according to the latest annual Kaiser Family Foundation employee health benefits survey.

Premiums for employer-provided family coverage rose $3,065 — 24% — from 2008 to 2012, the Kaiser survey found. Even if you start counting in 2009, premiums have climbed $2,370.

Why should we go forward with Obamacare, which requires the construction of these exchanges? Obama already broke his promise to cut health insurance premiums, and the full implementation of these exchanges would raise the premiums even higher. This is nothing but a ploy to justify the imposition of price controls on private health insurers so that they go out of business, and we are left with a fully government-controlled system. Then there will be no choice, no competition, waiting lists, a shortage of doctors and rationing of health care by un-elected bureaucrats. Do not give this man a second term.

Here are a few articles that I have been using lately to inform people about the problems with Obamacare:

It’s important to understand that people who oppose this law don’t oppose because we are just being contrary.  We have reasons.

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

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