Obamacare to create Great Doctor Shortages, Long Wait Times and Rationing of Health Care Services

Posted by PITHOCRATES - November 30th, 2013

Week in Review

How did African slavery arrive to the new world?  The New World was vast continents.  And there were just not enough settlers to farm on the scale required.  With a huge shortage of laborers the colonial powers tried enslaving the local population.  But it proved difficult to keep them enslaved.  As they were well familiar with the land.  And the indigenous population.  If they escaped they could disappear into the land and into the indigenous population.  Something an African slave could not do as well.  If at all.  Strangers in a strange land.  Unable to communicate with the indigenous population.  And unable to hide among them.  Who were probably just as hostile to them as they were to the white man taking their land.  Making escape from bondage much more difficult for the African slave than it was for the indigenous slave.  So the African slave proved to be a good fit for the colonial powers.  Allowing them to fill the shortage of labor by forcing the black man into bondage.  To provide their labor against their will to meet the demand of the ruling colonial powers.

Now there is a new demand that the government will struggle to meet (see Lack of Doctors May Worsen as Millions Join Medicaid Rolls by ABBY GOODNOUGH posted 11/28/2013 on The New York Times).

Dr. Ted Mazer is one of the few ear, nose and throat specialists in this region who treat low-income people on Medicaid, so many of his patients travel long distances to see him.

But now, as California’s Medicaid program is preparing for a major expansion under President Obama’s health care law, Dr. Mazer says he cannot accept additional patients under the government insurance program for a simple reason: it does not pay enough…

His view is shared by many doctors around the country. Medicaid for years has struggled with a shortage of doctors willing to accept its low reimbursement rates and red tape, forcing many patients to wait for care, particularly from specialists like Dr. Mazer.

Yet in just five weeks, millions of additional Americans will be covered by the program, many of them older people with an array of health problems. The Congressional Budget Office predicts that nine million people will gain coverage through Medicaid next year alone. In many of the 26 states expanding the program, the newly eligible have been flocking to sign up…

In California, with the nation’s largest Medicaid population, many doctors say they are already overwhelmed and unable to take on more low-income patients. Dr. Hector Flores, a primary care doctor in East Los Angeles whose practice has 26,000 patients, more than a third of whom are on Medicaid, said he could accommodate an additional 1,000 Medicaid patients at most.

“There could easily be 10,000 patients looking for us and we’re just not going to be able to serve them,” said Dr. Flores, who is also chairman of the family medicine department at White Memorial Medical Center in Los Angeles…

The health care law seeks to diminish any access problem by allowing for a two-year increase in the Medicaid payment rate for primary care doctors, set to expire at the end of 2014. The average increase is 73 percent, bringing Medicaid rates to the level of Medicare rates for these doctors.

But states have been slow to put the pay increase into effect, experts say, and because of the delay and the fact that the increase is temporary, fewer doctors than hoped have joined the ranks of those accepting Medicaid patients. “There’s been a lot of confusion and a really slow rollout,” Ms. Folberg said, “which unfortunately mitigated some of the positive effects…”

Dr. Paul Urrea, an ophthalmologist in Monterey Park, said he was skeptical of “blue-sky scenarios” suggesting that all new enrollees would have access to care. “Having been in the trenches with Medi-Cal patients who have serious eye problems,” he said, “I can tell you it’s very, very hard to get them in to see those specialists.”

Dr. Urrea said that when he recently tried to refer a Medicaid patient with a cornea infection to another eye specialist, he was initially informed that the specialist could not see the patient until February. “And this is a potentially blinding condition,” he added.

Travel long distances to see a doctor?  Long wait times?  A shortage of health care providers?  Low reimbursement rates?  Overwhelmed doctors?  A shortage of specialists?  You’d think your were reading about the UK’s National Health Service (NHS).  But this is just what the Affordable Care Act (aka Obamacare) is doing to Medicaid.  Which it will soon do to the rest of the American health care system.

So not only is the Affordable Care Act making health insurance unaffordable it will create doctor shortages that will lead to longer wait times.  Some waits stretching out over two months.  A wait so long that a patient may go blind from a treatable eye infection.  This is national health care.  People succumbing to their diseases as they wait for treatment that is being rationed out.  Which they have to ration as the number of patients far outnumber the number of doctors available to treat these patients.

So this is what Obamacare will do to the American health care system.  Give us longer waiting times.  Rationed care.  And people succumbing to their illnesses because of the long wait to see a doctor.  Funny as the Afford Care Act was to give affordable health insurance to all.  So everyone could live in a utopia where if they were sick they could go to a doctor and have everything covered.  Just pray you’re not one of those who can’t afford to pay the higher premiums and higher deductibles of Obamacare.  Because these people are being dumped into the overcrowded and underfunded states’ Medicaid systems.  Which will only get worse under Obamacare.  Especially with doctors leaving the Medicaid system.  Retiring early.  Or moving into concierge medicine.  Leaving ever fewer health care providers to tend to the swollen Medicaid ranks.

Not a good time to be a doctor.  For you have to be wary of a government that can’t find enough doctors to voluntarily meet the health care demand.  Especially one that has a Senate ‘rubber-stamp’ for its judicial appointments.  Thanks to Harry Reid and the nuclear option.  Changing the rules of the Senate by eliminating the filibuster for judicial appointments.  Which opens the door for a lot of illegal and unconstitutional law.  Such as new health care mandates issued by the executive branch that exceed its constitutional authority.  Which will be challenged.  But once these cases hit these Obama-packed courts you can guess the outcome.  Illegal and unconstitutional mandates will become law.  Which no doubt concern doctors in a health care system that has a doctor shortage and an explosion of new patients.

If a doctor wants to remain a doctor and get paid for his or her services he or she may find new requirements.  Such as mandatory salary caps.  Forced acceptance of Medicaid patients.  With ‘opting out’ made illegal.  Compelling doctors to work against their will.  Now forcing people to work against their will is nothing new.  When Roman taxes rose so high to pay for the bloated Roman state people quit their jobs to avoid paying taxes.  Then the Roman state made that illegal.  Bonding these people to their jobs.  And when they died their children were forced to continue in their place.  Giving Europe feudalism.  Where the masses worked the land against their will.  For the law prevented them from ever leaving the land they or any of their progeny were born on.  Could this happen to the American health care system?  If the state controls the health care industry and the courts, yes.  Which is why it is not a good time to be a doctor.

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National Health Care kills up to 2,000 Children a Year in Britain

Posted by PITHOCRATES - July 13th, 2013

Week in Review

Opponents of nationalizing health care say it will only lead to doctor shortages, a lowering of quality and rationing.  Proponents of Obamacare say that’s absurd.  For with government in charge of a large health care bureaucracy things can only get better.  Not worse.  Just look at the NHS in Britain (see British child death rates are ‘a major crisis’, says paediatricians’ leader by Yvonne Roberts and Denis Campbell posted 7/13/2013 on the guardian).

Five children die unnecessarily every day of conditions such as asthma, meningitis and pneumonia because NHS care for young people is badly organised and dangerously inadequate, the leader of Britain’s 11,000 specialists in children’s health warns.

About 2,000 children a year lose their lives because of an array of problems, which means the UK has some of the worst death rates among children up to the age of 14 in Europe, the president of the Royal College of Paediatrics and Child Health told the Observer. Branding the situation “a major crisis”, Hilary Cass said in an interview that sick children were at greater risk of dying because some GPs lacked paediatric skills, expertise was absent in too many small paediatric units, and there was a serious shortage of consultants. The college believes a lack of senior paediatric doctors is so acute that the safety of treatment cannot be guaranteed at every unit. Cass urges the NHS to instigate radical changes in how it treats children, including a centralisation of hospital services to reduce preventable deaths…

Her concerns are supported by the royal college’s new medical workforce census, a major biannual study among the UK’s 11,000 paediatricians to investigate the pressures on them. It identifies problems such as:

■ Sharply rising demand as more children contract non-communicable diseases such as asthma and obesity.

■ A chronic shortage of consultants, especially when hospital units are busiest.

■ Worryingly wide variations in the number of consultants in different parts of England, with 48 per 100,000 children aged 0-15 in London, but just 27 per 100,000 in the east of England.

Imagine that.  In the NHS where the government is in charge of a large health care bureaucracy there are doctor shortages, a lowering of quality and rationing.  Guess the proponents of Obamacare are wrong.  As moving American health care in the direction of British health care is wrong.  Unless loosing 10, 0000 children a year is okay with you.  (The U.S. has about 5 times the population of Britain.  So one would multiply their 2,000 deaths by 5 to approximate the U.S deaths we can expect with a government run health care system.)

If the left really cares about the children then they should repeal Obamacare.  For it could save up to 10,000 children a year.  Unless the left hates children.  Which they must if they don’t repeal Obamacare.  Because we can see where Obamacare can lead to by simply looking at what’s happening in Britain now.

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The Canadians are Cutting Doctors’ Medicare Reimbursements due to the Costs of an Aging Population

Posted by PITHOCRATES - May 5th, 2013

Week in Review

The United Kingdom has national health care.  Which is struggling to meet the demands of an aging population.  And is currently working on cutting their health care spending by £20 billion ($31.8 billion) to help stretch their limited resources meet the demands of their aging population.

Canada has private health care providers but a single-payer system.  So it’s not quite national health care.  But it is somewhat universal.  And something the proponents of Obamacare would settle for if they can’t get national health care.  But like the UK the Canadians are struggling to meet the demands of an aging population (see ‘Future of health care’ hangs on medicare talks posted 5/3/2013 on CBC News).

More than 200 doctors have voted in favour of supporting a lawsuit against the provincial government over medicare cuts, says the head of the New Brunswick Medical Society.

The doctors, who gathered for an emergency meeting in Fredericton on Friday to discuss the matter, were unanimous, other than one abstention, said president Dr. Robert Desjardins…

Desjardins said doctors are still willing to help Health Minister Ted Flemming find ways to cut $20 million from the health budget, but first things first.

“First and foremost importance is respect of the actual signed agreement,” said Desjardins.

“There’s not much of an incentive to discus the future of medicare when there’s no plan on the table and the signed agreement isn’t respected. So from there, what are we talking about?”

In March, the government announced plans to cut funding for doctors who bill medicare for each service by $18.8 million to $425 million and to cap that amount for two years.

The medical society, which represents about 1,700 doctors, contends that violates a fee agreement that expires next March.

Cutting doctors’ Medicare reimbursements?  That’s how Obamacare plans on bringing down health care costs in the United States.  Guess cutting doctors’ Medicare reimbursements isn’t the panacea they thought it would be.  As Canadian doctors actually want pay commensurate with their education, skill and experience.  Imagine that.

Becoming a doctor isn’t easy.  That’s why few people in the population become doctors.  And why countries that don’t pay their doctors well have doctor shortages.  Like they often do in countries with national health care.  Or in countries with a single-payer system.  Who look to break contracts to pay their doctors less.  To help stretch their limited resources meet the demands of their aging population.

Just something to look forward to under Obamacare.  People will at first praise the government for punishing those who choose to make a profit off of other people’s suffering.  But when doctors start leaving the profession and these people have to wait months for an appointment because of the doctor shortage they will long for a return to the old days.  When we had the finest health care system in the world.  And doctors got rich for being the best in the world.  How it once was.  Before Obamacare.

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