What if ObamaCare Stands?
Robert A. Hayden, DC, PhD, FICC
We are poised now for the Supreme Court to address the constitutionality of ObamaCare. This signature legislation for the Obama administration will become a central focus of the next presidential election this year.
What will be the consequences for US citizens if ObamaCare survives the legal and political tests ahead? It is difficult to imagine, in part because we have never embraced such a concept before. It is also difficult to imagine the impact of a bill that was passed before anyone could read it.
We might look to the state of Massachusetts for answers. This state was used as a model or ObamaCare. In Massachusetts now, 97% of that state's residents now have health care. This includes a half-million new consumers into a system that was not ready for them. There were unintended and unpredicted consequences of this influx of consumers. Here is a sneak peak at what we might expect should ObamaCare come to fruition in America.
According to the Massachusetts Medical Society, the waiting time for a new patient seeking a primary care physician varies between 36 and 50 days. About half of their internal medicine doctors have closed their doors to new patients. Because the physician population in Massachusetts is much higher than most other states, other states may expect much longer waits for patients seeking care due to massive shortages of primary care doctors.
The Association of American Medical Colleges is predicting a shortage of 46,000 primary care doctors by 2025, just over a decade from now. This is certainly influenced by physicians, nurse practitioners, and physician assistants gravitating toward more lucrative specialties. It may also be influenced by the thought processes of promising young students, who may be looking at dismal prospect for private practice and electing not to pursue a career in healthcare.
Mathematics will produce shortages in another important way. If ObamaCare becomes reality, the federal government will set fees for providers. It is possible that providers will not be able to opt out of the program, so they will be trapped. It is already true for many providers that if they fill their waiting rooms with Medicare patients, they will have to close their doors because Medicare cuts fees routinely sometimes in excess of 90%. Independent practices are small businesses and simply will not be able to make their expenses and will close.
We have seen numerous articles and opinions warning us that physicians will retire or abandon their careers rather than work under the circumstances that will be created by socialized medicine. The trend of independent medical practices being absorbed by business interests is already evident here in Griffin, and the prediction is that two thirds of them will be gone soon.
When sick patients cannot find a primary care doctor to see them, this creates an emergency-- and off to the emergency room many will go. Hospital emergency rooms are obscenely expensive, and this can only increase cost and waiting time for emergency care. The experience in Massachusetts was a 7% increase in emergency room traffic.
Massachusetts is now considering cutting health care benefits to about 30,000 legal immigrants in order to save their system for citizens. Budget cuts now threaten indigent care given to patients in Boston. On a national scale, there may be millions of formerly insureds pouring into the system because the cost of healthcare could not be borne by their employers anymore. Imagine what would happen if ObamaCare floods and additional 12 to 20 million illegal immigrants into Medicaid. The system will simply collapse.
It is likely that such a logjam will increase traffic to nonphysician providers who can address many of the issues that primary care physicians would treat, providing a less expensive and more immediate path to care. Since the 1990s, patients have already been voting with their healthcare dollars for this option, visiting nonphysician providers overwhelmingly more than all medical specialties combined. The most numerous physician-level provider in this category are chiropractors, and they are gearing up for the future.
What can patients do? First, get healthy and stay that way. Second, establish a relationship with the healthcare provider(s) of your choice, while you still have a choice, and maintain that relationship. Third, get familiar with the issues, and vote your conscience.