Obamacare ignores looming doctor shortage
By Phil Kent
The national healthcare debate swirls as this is being written, with President Barack Obama having issued a barrage of false claims when touting the Democrats’ congressional legislation. The right answer to those claims— and not just from Republicans but from a growing number of Democrats— is that under this legislation you won’t always get to keep your doctor, the program “isn’t paid for,” insurance premiums will undoubtedly rise, Medicare funding will be reduced by $500 billion over 10 years and, ultimately, Obamacare won’t reduce costs by adding approximately 30 million more insured people.
Then there’s the sensitive issue of abortion. It’s hard to see how any version of the Democrats’ legislation can stop that procedure from happening— and being paid for in part or directly by taxpayers. Furthermore, all versions of Obamacare contain loopholes whereby illegal aliens can get health coverage. That’s because there is weak enforcement and verification provisions for all the 50 states.
As for how Obamacare would impact on the states, Georgia Lt. Gov. Casey Cagle has warned of just one devastating impact. He notes Georgia’s Medicaid-eligible population would balloon as the number of persons dramatically increase in the federal government-run Medicare program. Such an additional financial burden would “crush” the already strained-to-the-limit Georgia budget. And, Cagle estimates, this would occur with the budgets of at least 13 other states.
No matter what happens on Capitol Hill, let’s remember that Obamacare does not address a critical problem: our nation will soon face an alarming shortage of physicians.
Herbert Perdes, president and CEO of New York-Presbyterian Hospital, is blunt:
“If the doctor shortage is not addressed and healthcare reform is signed into law, millions of Americans will likely find themselves able to obtain insurance for the first time— but may be unable to find a doctor without a long delay. Why? Because expanding the number of insured patients but not the number of doctors will only increase the demand for services that already must meet the demands of an aging population. We must make sure there are enough health professionals to meet those new demands.”
The U.S. will face a shortage of at least 125,000 doctors by 2025, according to the American Association of Medical Colleges. Currently, there are about 700,000 active physicians today. One Atlanta doctor, dermatologist Alex Gross, underscores that while baby boomers will be living longer and thus will require more care while, as many as one-third of the physicians now practicing will likely retire in 10-15 years.
Interviewed at a “Tear Up Your AARP Card” rally sponsored by the Atlanta-based American Seniors Association (ASA), which with 200,000 members is the conservative alternative to the AARP, Dr. Gross called on Congress to institute malpractice reform and think about how to raise doctors’ and nurses pay and reduce the amount of debt doctors currently have to assume.
Dr. Perdes, writing in The Wall Street Journal, wants to shift unused federal training funds to hospitals that need more positions, but only if those funds are used for primary care. Another idea, he says, is to move primary care physician training out of hospitals and into federally qualified health centers. And yet another idea is to shift training dollars from doctors and instead use them to train additional nurses and other medical professionals.
While his ideas won’t necessarily increase the numbers of doctors, the first two would at least increase the number of primary-care doctors at the expense of the number of specialists.
There is general agreement that once doctors actually start treating patients “they are squeezed between what they earn from the government programs and insurance companies on one side, and escalating malpractice insurance rates on the other,” Perdes writes. Meanwhile, he notes, “specialists can often charge more and pay less in other costs than primary care doctors— and the reality is that many doctors cannot afford to go into primary care.”
So no matter what the ultimate fate of Obamacare, forward-looking members in both parties in Congress will still have a big, unfinished job to do: Institute a strategy and then spell out concrete steps to alleviate the looming doctor shortage.