I have long predicted that health care in America will follow education’s trajectory, which will itself continue to trace a long unpalatable arc into the sea.
Regarding the former, it is a “free” entitlement for which we are all going to pay dearly. Though of course that statement requires qualification: it is a benefit for which those who pay are going to do dearly. And for an increasing number in the future, it is something they are going to pay strictly for the benefit of their teeming new fellow Americans. For like education in many areas presently, they’ll pay for both someone else’s public and their own private.
This will open an entirely new front in the war of white liberals against their implacable hypocrisies. For just as those tolerant diversity lovers now sniff about for “good schools,” so to in the future will the ACA supporters scuttle in search of “good doctors.” The latter being defined (politely sotto voce) as those not participating in Obamacare.
Over 214,000 doctors won’t participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows. That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs. It’s also about a quarter of the total number of 893,851 active professional physicians reported by the Kaiser Family Foundation.
In January, an estimated 70% of California’s physicians were not participating in Covered California plans.
Here are some of the reasons why:
1. Reimbursements under Obamacare are at bottom-dollar – they are even lower than Medicare reimbursements, which are already significantly below market rates. “It is estimated that where private plans pay $1.00 for a service, Medicare pays $0.80, and ACA exchange plans are now paying about $0.60,” a study by the think-tank American Action Forum finds. “For example, Covered California plans are setting their plan fee schedules in line with that of Medi-Cal-California’s Medicaid Program-which means exchange plans are cutting provider reimbursement by up to 40 percent.”
2. Doctors are expected to take on more patients to make up for the lost revenue, but that’s not happening, because primary care doctors already have more patients than they can handle. “Furthermore, physicians are worried that exchange plan patients will be sicker than the average patient because they may have been without insurance for extended periods of time, and therefore will require more of the PCPs time at lower pay,” says the study.
The study also points to two reasons that doctors might not get paid at all:
3. An MGMA study indicates that 75% of ACA patients that had seen doctors had chosen plans with high deductibles. Given that most of the patients are low-income, doctors are concerned that the patients cannot meet the deductibles and they will get stuck with the bill.
4. HHS requires that insurers cover customers for an additional 90 days after they have stopped paying their premiums: the insurer covers the first 30 – but, it’s up to the doctor to recoup payment for the last 60 days. This is the number one reason providers are opting to not participate in the exchange plans. Currently, about a million people have failed to pay their premiums and had their plans canceled.
So, Obamacare is asking doctors to take on sicker patients for less money, with the risk of not getting paid at all? No wonder doctors are running from these plans!
If the figures cited above are accurate, they represent quite an indictment. Because the bother for libs is that you can make healthcare cheap, you just can’t make anyone provide it as such. Though that also is a statement requiring a terrible red qualification.
Though contra to the article’s concluding implication, not all doctors are going to be fleeing from government healthcare. A great many will eagerly offer their services to the public. Those who remain will have names like Drs. Janwari and Kumar. And they will all be brilliant conscientious physicians that America desperately needs.
Can any of our more seasoned readers recall a brief period in time when Americans stumbled along without the benevolent aid of hyper-competent foreigners? No me neither. Yet it is they desperate to come here rather than we there. So who is actually more competent? I wonder which body part between feet and tongues is telling the truth?
No matter xenophobes, they’ll be with the government and here to help. And so public American healthcare will come to be a system of whites paying for Mexicans to be treated by Indians.
Of course all of those many bumbling legacy doctors aren’t simply going to stop practicing. They will instead begin offering care to legacy patients who will be forced to pay out of pocket to avoid Rosseta Stones and six-month waits for a burst appendix.
The result will be two tier healthcare. I wonder if Caplan or Cowan will be able to marshal economic charts sufficiently compelling to persuade their own wives not to seek private physicians for their children. Hopefully so. Though a great many won’t be so logical or tolerant. We’ll call these people…liberals.
Oh, umm, hey…Do you know any good doctors in town? It’s ok if they don’t participate in the ACA. You know what we mean…right? 😇