Obamacare is expected to increase patient demand for medical services. Combine that with a worsening shortage of doctors, and next year you may have to wait a little longer to get a doctor’s appointment. And the crowded emergency room may become even more so. …
What happened in Massachusetts in 2006 when the state’s mandated health insurance rules went into effect illustrates the impending national problem.
When the Massachusetts law kicked in, wait times to get an appointment at primary care physicians’ offices increased significantly, and they’ve remained high ever since, according to anannual survey from the Massachusetts Medical Society. And Massachusetts has the second highest physician-to-population ratio of any state.
When patients couldn’t get doctor’s appointments they once again turned to emergency rooms. A Harvard study found all 11 of the emergency rooms that researchers studied in Massachusetts became busier after the law went into effect.
Read more at CNN.com.
Paul Hsieh, MD writes:
Free-market economists have long known that “controls breed controls.” In health care, leading Obamacare supporters are now proposing unprecedented new government controls over all medical spending — private as well as public — to “solve” problems caused by prior controls. Welcome to ObamaCare 2.0. …
In particular, voters should be aware of five key points:
1) This means rationing. …
2) Get ready for the lobbyist feeding frenzy. …
3) The government will exert increasing control over how doctors can practice. …
4) Controls breed controls. …
5) We need free-market reforms more than ever. …
The proposed cap on private medical spending would also prevent Americans from spending their health care dollars as they wished. Obamacare 2.0 would mean unprecedented government control over our health care — and our lives.
Read more at PJ Media » In Top Journal, Obamacare Boosters Push ‘Global Spending Target’.
In the Wall Street Journal, Grace-Marie Turner writes:
Mr. Romney has indeed backed himself into a corner by insisting on defending his health plan while attacking ObamaCare. In the Oct. 11 debate at Dartmouth College, Mr. Romney said: “[W]e all agree about repeal and replace. And I’m proud of the fact that I put together a plan that says what I’m going to replace it with.”
Does he really mean that he wants to use Massachusetts as a model for his “replacement” plan? No wonder voters are worried.
Unless Mr. Romney takes steps to conform his position with reality, he will have trouble convincing voters he is serious about repeal and will have an even harder time mapping a clear plan on health reform should he be elected president.
Read the whole article: Grace-Marie Turner: Scoring Last Week’s RomneyCare Debate – WSJ.com.
John Goodman explains how Massachusetts residents have long waits for medical appointments, and how this problem will spread nation wide as ObamaCare is implemented. His key point:
Are you having difficulty finding a doctor who will see you? If you are, brace yourself. Things are about to get a whole lot worse.
Right now, the biggest problems are in Massachusetts. …For the state as a whole, the average wait to see a new family doctor is one month. More than half of all family doctors and more than half of all internists are not accepting new patients at all.
What if you live in another state? Just wait two more years. In Massachusetts people are lined up waiting to see doctors because of the health reform championed by the former governor (RomneyCare). And as Barack Obama has said on more than one occasion, RomneyCare is the model for ObamaCare.
Why? In both the Massachusetts health plan and the new health care law the mistake is the same: insuring the uninsured, but doing nothing to enable the medical community to deliver more care.
Read the whole article: Why the Doctor Won’t See You – John C. Goodman.
Paul Hsieh, MD writes:
Romney’s claim that the Massachusetts plan didn’t include price controls may have been technically true at the time the law was passed. But he helped create an unsustainable system that has quickly and predictably led to price controls — with still more to come. Hence, Romney’s claim is disingenuous if not downright misleading.
Read the whole article: PJ Media » The Truth About RomneyCare.
Margery Eagan of the The Boston Herald writes:
Now, the state of Massachusetts is grinding [Lauren and Nick Destito] into the dirt. The reason: the health insurance the Destitos bought, paid $750 monthly premiums on and repeatedly used at doctor visits apparently does not pass muster with the state’s mandatory universal health insurance law. Now the Destitos, both 50 and already on the brink of financial ruin, are facing a $3,000 state fine. …
“The stress will kill me before anything else,” Lauren Destito joked nervously yesterday just before her appeal hearing with the state’s Health Connector. She was so worried she asked her state representative, Dan Winslow, to listen in on the conference call. With hearing officer Irene Herman’s knowledge, I listened in, too.
“I would just like to say that we did make the effort and purchased a plan,” Destito told Herman. “I don’t understand why we’re in this situation at all.”
Because, Herman explained, the state must establish if her family could afford other, better insurance, and that affordability is determined “not, unfortunately, from your perspective but from the state agency’s view.”
In other words, the state decides how much health insurance you can afford — not you.
Read more: Health-care agency sick – BostonHerald.com.
Does fee-for-service medicine create incentives for “excessive care”? An article in the New York Times says so. Massachusetts legislators are
working toward a plan that would encourage flat “global payments” to networks of providers for keeping patients well, replacing the fee-for-service system that creates incentives for excessive care by paying for each visit and procedure. …
[Massachusetts health reform in 2006] did little to slow the growth of health costs that already were among the highest in the nation. A state report last year found that per capita health spending in Massachusetts was 15 percent above the national average. And from 2007 to 2009, private health insurance premiums rose between 5 and 10 percent annually …
It’s not fee-for-service that creates incentives for excessive care. As John Goodman explains, fee-for-service works fine for lawyers and restaurants, as well as countless other services. The problem is that, as Goodman writes:
what is it that makes health care different? There are three things: (1) third-party payment of the bill, (2) rationing by time and not money, and (3) an inability on the part of providers to repackage and reprice their services.
Bottom line: The fundamental problem in health care is not that we are using too much of one payment mechanism and too little of another. The problem is that the person who benefits from the service is not the same as the person who pays the bill.
Read his whole post: Is Fee-for-Service Payment the Problem?