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Here’s A Healthcare Stimulus Package Tip … Reserve a Doctor Before It’s Too Late!

Posted on | July 20, 2009 | 1 Comment

The elements of health reform just aren’t adding up when you assess the limited number of personnel available to provide quality and timely care.

I may be reminiscent of a broken record, but the healthcare sector does not currently have sufficient physician or allied health workforces to ‘absorb’ another 47 million people actively seeking clinic appointments and surgeries. Many Americans have known for quite some time that the acquisition of health insurance does not equate with the ability to receive timely health care….or healthcare at all!  Even in their relentless pursuit of healthcare legislation, Obama administration officials had to acknowledge that we may not have enough providers to cover the needs of those who seek care. (1)

One can’t help but feel a sense of urgency developing in Washington with Congress rushing to draft legislation while standing on a burning platform.  Good decisions aren’t made when political timelines are used to compress and distort the issues into some type of deliverable package.  There are some burning (no pun!) issues facing this important and historic effort that will most definitely impact on whatever legislation is adopted.

  1. There are not enough primary care physicians to care for all Americans in clinics.
  2. There are not enough surgeons to operate on all Americans in our O.R.s
  3. There is an undersupply of all kinds of physician specialists in America.
  4. America’s physicians are ‘graying’ faster than the population.
  5. Many medical schools cannot substantially increase their enrollments quickly because of their inability to teach medical students in the clinical clerkship (3rd and 4th) years.  These mentoring doctors are too busy caring for the increased number of sicker and elderly patients at a rate of eight patients every hour, just to earn a living.
  6. The type of health insurance does make a difference.  In New York State, only 38% of new patients with one type of insurance find primary care physicians who will accept them.   The insurance is Medicare.  Only 50% of the MDs accept Medicaid, as it is not worth the cost of doing the paperwork for the $25.00 clinic visit payment.2
  7. Doctors are still incurring massive educational debt in excess of $200,000 and seek out the higher paying specialties to help pay it off.
  8. It’s incongruous to think that one can (a) provide insurance for everyone, (b) guarantee timely access to care, (c) guarantee high quality care and (d) pay less for this care.
  9. Every analysis ever done anywhere in the world has concluded that “more doctors result increased healthcare cost”.  As more people have greater access to care, doctors diagnose conditions earlier and treatment is sooner started.  Delaying access to care (rationing) often prevents timely diagnosis resulting in no effective treatments being offered – costs are then reduced!
  10. Minute Clinics in pharmacies and Wal-Marts, urgent care centers, and ERs will be inundated with patients waving newly acquired Medicare/caid cards seeking government promised medical care.
  11. Intense competition between  allied health professionals and physicians will likely drive healthcare into a multi-tiered delivery system where the premier level will include ‘concierge physician care’ for those who can afford to pay the ‘retainer’ fees for private, personal attention.
  12. Congressional leaders will still be buffered from the realities of healthcare reform because their premium health packages will remain unchanged.
  13. Lack of medical liability reform will still compel physicians to practice defensive medicine, and order non-essential tests or X-rays demanded by consumer patients, to avoid lawsuits that can extend beyond their malpractice limits into their personal finances.
  14. The eventual demise of private health insurance as a national health service evolves will result in physicians reducing their patient contact time from 55 hours to 40 hours just like in other countries.
  15. Those physicians, who can retire early, will retire early, further reducing the availability of physicians needed to provide care.
  16. Don’t discount the out migration of American physicians to Canada and other countries as foreign practice arrangements become more desirable to U.S. trained doctors.
  17. Beware of the Attorneys General stepping up investigations into “fraud and abuse” to collect monies in order to pay for the increased health costs.  The healthcare payment system is so convoluted, confusing, contradictory and complex that virtually every physician can be unknowingly “guilty” of over- or under-billing so as to be a target.

Healthcare reform is too important and too complex to believe that a quick fix by August will result in a favorable and satisfying outcome for most Americans.  It is more likely that inequities and inaccessibility will intensify, with the unintended consequences of more Americans, even those already with health insurance, being denied timely access to quality care. Congress will then reflexively act to modify the reform inequities as they surface, akin to contractors building a bad structure and then remodeling it as the tenants move in – achieving mixed results.

My suggestion to those who need healthcare is to be conservative and stay with an existing plan if you have one, or join one if you can, that retains a network of physicians who will care for you and your family even if co-pays double or triple.  When the dust settles, healthcare is not likely to remain an entitlement but become a partially funded, heavily taxed mandate for every American.

There simply is no free lunch.   –MJL

1 Pear, R. Shortage of Doctors an Obstacle to Obama Goals.  NY Times, April 27, 2009

2 Siegel, M. Opinion; When Doctors Opt Out. WSJ April 17, 2009

Comments

One Response to “Here’s A Healthcare Stimulus Package Tip … Reserve a Doctor Before It’s Too Late!”

  1. Gerald
    November 11th, 2009 @ 12:38 am

    i hope that those Stimulus Package coming from the government would really kick start the Economy. the economic recession has been very bad on my business. ***

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