Tuesday, July 31, 2012

Obamacare To Make Doctor Shortage Worse

There I was, minding my own business, when suddenly my television started telling me about all the benefits I could get under Obamacare. Blech. What’s worse, it wasn’t even an Obama campaign ad. Nope. This piece of propaganda was produced by HHS with my very own tax dollars. Grrr. And not surprisingly, they left out a very key detail called a doctor shortage. Let’s discuss.

Grrr. . . Seriously, W.T.F.?: How can HHS put an ad on my television pimping Obama’s “signature” achievement, i.e. the one he won’t mention on a bet? Well, disturbingly, this is legal. Federal agencies are not allowed to engage in partisan politics. This goes back to the 1930s when the Republicans tried to suck the politics out of the federal bureaucracy. Up to that point, the agencies were considered spoils of the process and the parties used them to hand out jobs and favors and to extract favors in return. Laws like the Hatch Act put an end to that.

So how can HHS run an ad that is essentially a pro-Obama campaign ad? Believe it or not, federal agencies are allowed to advertise the kinds of benefits they offer the public. That’s right. They are actually allowed to put out ads telling people to come get “free” stuff, i.e. things paid for by the taxpayers. This falls under the category of performing their mission because their mission requires advising the public about the benefits available to them.

What HHS technically was doing was telling the public about the new benefits being offered so that those of us who qualify could sign up for them. It just so happens that in so doing, they were basically campaigning for Obama by telling everyone about the great new law offering all the free healthcare you can sponge. Grrr.

As an aside, this isn’t the only instance of this during this election cycle. The Department of Agriculture has actually teamed with the government of Mexico to advertise American food stamps to any eligible Mexicans. Grrrrrr.

Is There A Doctor In The House?: Anyway, HHS left out one key point in their expositions on the “virtues" of Obamacare: there aren’t enough doctors. The Association of American Medical Colleges estimates that without Obamacare, the nation will be short 62,900 doctors by 2015 and 100,000 by 2025. With Obamacare, the number will exceed 125,000 by 2025. That’s an interesting admission. Why would a law that was meant to make everything perfect make the doctor shortage worse? There’s even a part of Obamacare which was supposed to address this! So how can this be? Well, the law only authorizes 3,000 new doctors, not the 125,000+ needed. Moreover, the law itself is driving doctors from the profession.

Further, I think these numbers are vastly understated. According to official estimates, 30 million people are about to get health coverage in 2014. If the system already has a shortage of doctors, how much worse will it get when that happens? The government recommends 60-80 primary care physicians and 85-105 specialists for every 100,000 people. This means, 30 million “new” people will need an additional 21,000 primary physicians and 28,500 specialists by next year. It apparently takes ten years to train a doctor. So unless someone expected Obamacare in 2004 and started cranking up the med schools, we’re going to be 49,500 additional doctors short starting next year because of Obamacare. And all of this is before another 25 million people join the ranks of Medicare, meaning they will need a lot more care than they presently receive, and they will need it on the taxpayer’s dime.

The result of this doctor shortage will be felt in two ways. Some people won’t be able to find care. A good example of this can be seen in Medicaid. In 2008, less than half of primary care physicians were willing to take new Medicaid patients. Why? Because they lose money on each. Obamacare expands Medicaid. In fact, one-third of the 30 million people who will be “covered” will be covered through an expansion of Medicaid. Few of those people will be able to find doctors.

The other way this will be felt will be as “an invisible problem.” This means that patients will still be able to see their doctors and get care, but the process will become slow and difficult because of overcrowding. Some people will need to drive long distances. Many will languish on waiting lists for care. And a lot of people will end up using the emergency rooms as a substitute. In effect, Obamacare will make the very problems it was supposed to cure worse. Imagine that.

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