For practicing physicians, the problems with ObamaCare go well beyond spiraling-out-of-control premiums (the average increase for the 2017 midlevel health plans is 25 percent) and the flight of the insurance providers (down from 232 to 167).
True, ObamaCare is a failed Ponzi scheme. The insurers who remain in the game are being forced to raise premiums because healthy young people aren’t signing up, which would help preserve profits.
But the heart of the problem with the heavily subsidized, unwieldy ObamaCare plans is found in the doctor’s office. You come in demanding care, and we clog up the whole health care system when we dispense it.
First, ObamaCare plans have many fewer choices attached to them. An analysis of the 2015 exchanges in Florida, California, Texas, Georgia and North Carolina by the market research firm Avalere Health found plans included 34 percent fewer providers than commercial plans offered outside the exchanges. This means I am spending precious time — yours and mine — during your visit trying to find an orthopedist for your knee pain or an allergist for your hives or a gastroenterologist to refer you to for your colonoscopy.
I frequently find myself squinting at a list of doctors whose names I don’t recognize. And if my hospital doesn’t accept your plan, I may be sending you to get your lab work in one facility and your chest X-ray in another, which means my staff has to scramble to piece all your results together when you call for them two days later.
And what about your $5000 deductible? Most of my ObamaCare patients who proudly sport their new coverage are not prepared to discover that it doesn’t cover the basic services they need. I spend way too much time — yours and mine and my next patient’s — trying to convince you to get X-rayed for your bad cough or ultrasounded for your thyroid nodule as soon as you discover that the payment (despite your insurance) will have to come out of your own pocket.
Meanwhile, most of my face time with you has been replaced by computer time, where I enter your data (a 2009 federal law mandates electronic medical records) and you find yourself looking at my back for much of the visit. I don’t want anyone to feel sorry for doctors — it is still a privilege to take care of you, and most of us still make a decent living — but the fact is that my reimbursements for this watered-down insurance are decreasing as fast as your premiums are rising.
And it isn’t just ObamaCare that’s affecting quality of care in the doctor’s office. It’s all government-run insurance. Medicare has become a highly regulated, lower quality insurance that’s particularly cumbersome to work with, because the elderly tend to have more medical problems. The Kaiser Family Foundation reported that 21 percent of primary care physicians in 2015 were not taking new Medicare patients. And though the ObamaCare Medicaid expansion has taken hold in 32 states, a 2012 study in Health Affairs revealed that almost a third of physicians won’t see new Medicaid patients.
Hillary Clinton, if she’s elected president, aims to increase ObamaCare subsidies, provide a public option at the state exchanges, offset deductibles with tax-free subsidies of up to $5000 per family, provide full coverage for the first three sick visits in a year, expand Medicaid to all 50 states and lower the eligibility age for Medicare.
All of this sounds great, until you consider that it is likely to cost hundreds of billions of dollars and have no impact whatsoever at the doctor’s office — where we are clogged with low-paying, low-quality insurance, with no relief in sight.