Posted on 12/14/2013 5:56:58 AM PST by Kaslin
At this point we have no idea how many people will become newly insured under ObamaCare. For the first year out, the number of people with insurance may actually go down! But the administration's goal is to insure an additional 30 million people and eventually a lot of those people will acquire health plans. When they do, the economic studies predict that they will try to double their use of the health care system.
Adding to this increased demand will be new mandated benefits. The administration never seems to tire of reminding seniors that they are entitled to a free annual checkup. Then there are new benefits for women, including free contraceptives. And all of us will be entitled to a long list of preventive services — with no deductible or copayment.
But the health care system can't possibly deliver on all these promises. The original ObamaCare bill actually had a line item for increased doctor training. But this provision was zeroed out before passage, probably to keep down the cost of health reform. The result will be increased rationing by waiting.
Take preventive care. The health reform law says that health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force. What would that involve? In the American Journal of Public Health, scholars at Duke University calculated that arranging for and counseling patients about all those screenings would require 1,773 hours of the average primary care physician's time each year, or 7.4 hours per working day.
And all of this time is time spent searching for problems and talking about the search. If the screenings turn up a real problem, there will have to be more testing and more counseling. Bottom line: To meet the promise of free preventive care nationwide, every family doctor in America would have to work full-time delivering it, leaving no time for all the other things they need to do.
When demand exceeds supply in a normal market, the price rises until it reaches a market-clearing level. But in this country, as in other developed nations, Americans do not primarily pay for care with their own money. They pay with time.
How long does it take you on the phone to make an appointment to see a doctor? How many days do you have to wait before she can see you? How long does it take to get to the doctor's office? Once there, how long do you have to wait before being seen? These are all non-price barriers to care, and there is substantial evidence that they are more important in deterring care than the fee the doctor charges, even for low-income patients.
For example, the average wait to see a new family doctor in this country is just under three weeks. But in Boston, with ObamaCare-type reform, the wait is about two months.
When people cannot find a primary care physician who will see them in a reasonable length of time, all too often they go to hospital emergency rooms. Yet one study found up to 20% of the patients who enter an emergency room leave without ever seeing a doctor, because they get tired of waiting. Be prepared for that situation to get worse.
When demand exceeds supply, doctors have a great deal of flexibility about who they see and when they see them. Not surprisingly, they tend to see those patients first who pay the highest fees. A New York Times survey of dermatologists in 2008, for example, found an extensive two-tiered system. For patients in need of services covered by Medicare, the typical wait to see a doctor was two or three weeks, and the appointments were made by answering machine.
However, for Botox and other treatments not covered by Medicare (and for which patients pay the market price out of pocket), appointments to see those same doctors were often available on the same day, and they were made by live receptionists.
As physicians increasingly have to allocate their time, patients in plans that pay below-market prices will likely wait longest. Those patients will be the elderly and the disabled on Medicare, low-income families on Medicaid, and (if the Massachusetts model is followed) people with subsidized insurance acquired in ObamaCare's newly created health insurance exchanges.
Their wait will only become longer as more and more Americans turn to concierge medicine for their care. Although the model differs from region to region and doctor to doctor, concierge medicine basically means that patients pay doctors to be their agents, rather than the agents of third-party payers such as insurance companies or government bureaucracies.
For a fee of roughly $1,500 to $2,000, for example, a Medicare patient can form a new relationship with a doctor. This usually includes same day or next-day appointments. It also usually means that patients can talk with their physicians by telephone and email. The physician helps the patient obtain tests, make appointments with specialists and in other ways negotiate an increasingly bureaucratic health care system.
Here is the problem. A typical primary care physician has about 2,500 patients (according to a 2009 study by the Centers for Disease Control and Prevention), but when he opens a concierge practice, he'll typically take about 500 patients with him (according to MDVIP, the largest organization of concierge doctors). That's about all he can handle, given the extra time and attention those patients are going to expect. But the 2,000 patients left behind now must find another physician. So in general, as concierge care grows, the strain on the rest of the system will become greater.
I predict that in the next several years concierge medicine will grow rapidly, and every senior who can afford one will have a concierge doctor. A lot of non-seniors will as well. We will quickly evolve into a two-tiered health care system, with those who can afford it getting more care and better care.
In the meantime, the most vulnerable populations may have less access to care than they had before ObamaCare became law.
They have a plan for that.
The only chance at repeal is not losing the last little bit in Congress and not regaining the Senate. But there are plenty of bashers, and they’re not around to help retake the Congress — nope, they’ll profess their intent to vote “third party”. That’s what astroturf does.
Too bad none of those people are actually conservatives.
Look for a blue British phone booth with the words “Police Box” on it, that Doctor will always see you.
They don't care about what you want.
As for labeling people that don't see things the way you do as astroturf... you can pound sand. I'll be going door-to-door to support Stockman over Cornyn in the primary.
I won't vote for Cornyn in the general.
/johnny
Well you may not be able to see a doctor but atleast you will have insurance.
This whole scheme was a scam from the start from both sides of the aisle. All they focused on was the importance of getting insurance as if that was the end in itself and too many people on both sides of the aisle bought it.
“When demand exceeds supply in a normal market, the price rises until it reaches a market-clearing level”
There is also the option of increasing supply of medical services - perhaps to lesser qualified individuals providing the routine “lookup table” sort of care.
The bottom line is that Obama has succeeded in creating the environment where a “medical black market” can flourish. If people want medical care, increasingly, that’s how they’ll have to get it.
That 3 week wait time seems right for new patient appointments in my part of NC.
Yeah, that’s not how most physician offices work. They will most likely tell you to try the local urgent care or refer you to the ER.
And just wait till they start issuing orders to the doctors to match client with the care required....and prescriptions....don't forget all those complex prescription orders.
I see not just amputations on the wrong limb....but on the wrong patient.
and don't expect quick response for a broken arm:
And so you have an acute appendix....?
Mark Wattson, 35, from Swindon may have been the victim of botched surgery after he had to have his appendix removed twice
To his shock, surgeons from the same team told him that not only was his appendix still inside him, but it had ruptured - a potentially fatal complication.
In a second operation it was finally removed, leaving Mr Wattson fearing another organ might have been taken out during the first procedure.
The blunder has left Mr Wattson jobless, as bosses at the shop where he worked did not believe his story and sacked him.
Mr Wattson told of the moment he realised there had been a serious mistake.
'I was lying on a stretcher in terrible pain and a doctor came up to me and said that my appendix had burst,' he said.
'I couldn't believe what I was hearing. I told these people I had my appendix out just four weeks earlier but there it was on the scanner screen for all to see.
'I thought, "What the hell did they slice me open for in the first place?"
'I feel that if the surgery had been done correctly in the first place I wouldn't be in the mess I am today. I'm disgusted by the whole experience.'
Mr Wattson first went under the knife on July 7 after experiencing severe abdominal pain for several weeks. He was discharged but exactly a month later he had to dial 999 after collapsing in agony. Mr Wattson
Mr Wattson was readmitted to the Great Western Hospital in Swindon after his appendix ruptured.
Nurse will see you now
130,000 elderly patients killed every year by ‘death pathway’, claims leading UK doctor
by Thaddeus Baklinski Thu Jun 21, 2012 10:02 EST Tags: euthanasia, patrick pullicino, uk
LONDON, June 21, 2012 (LifeSiteNews.com) - An eminent British doctor told a meeting of the Royal Society of Medicine in London that every year 130,000 elderly patients that die while under the care of the National Health Service (NHS) have been effectively euthanized by being put on the controversial Liverpool Care Pathway (LCP), a protocol for care of the terminally ill that he described as a “death pathway.”
Sit back and enjoy your Obamacare.
We've now funded 0Care, for two years. We'll see how that helps maintain/increase our hold in the House.
We'll disagree on who the astroturfers are, around here. And, we'll see how Ryan's budget/0Care funding/military pension defunding helps in the next election. Also, bashing conservatives, like Midge and Weeper have done, is NOT helping, at all.
The Democrats are bitching now because they did not extend Employment Insurance past 26 weeks. They think that is a period of time that is “too short.”
Wait until 26 weeks is the time it takes to get an appointment with the doctor on their exchange plan, they will think that is “too long.”
Then when they have to pay the $12,000 deductible up front before their exchange plan pays anything, they will complain that that is not fair.
Just tell them they got what they voted for !!!!
Friends! I think we’ll have to see what time tells on who “owns it.” We who watch these things closely are rightfully angry with Boehner’s House for funding it, so in that regard the GOP “owns it.” But people who watch, but not as closely, see that it passed without any GOP votes (and the GOP House has repeatedly voted to repeal), so in that regard the Rats “own” it.
What will matter in the end will be if the majority of the non-observant voters believe what the press will surely tell them, and that is the Rats own the law, but the GOP owns everything that’s wrong with it.
If you like your lack of care, you get to keep your lack of care. Period.
You also get to pay a nice tax of 1% of your gross income this coming year and eventually 2.5% of it if you don't choose to participate in another mortgage payment-sized bill and huge deductibles - plus you get to keep your lack of care. Period.
What's there not to like about this highway robbery, er, I mean "health care"?
Then, ironically, you’ll have health care insurance, but no health care.
There is no such thing as free contraception. We all know that this is worked into the premium price, but moreover, all physicians must conduct a history and physical before prescribing a drug, even birth control pills, to a new patient. Even existing patients need an evaluation before receiving a new prescription. Doctors foolish enough to write prescriptions for “patients” that they have never seen usually receive a reprimand from the state medical board.
The doctors fees will need to be paid up front with these enormous deductibles. Just wait until January when these suckers thing they will be getting something for nothing.
This is in SW Pennsylvania, near Pittsburgh, home of some of the best hospitals and top medical schools in the country . . . and, by extension, some of the best doctor to patient ratios in the country as well.
I have a better than average medical plan from work, but it was still going to take over one month. So I did some research on-line and found that frankincense was effective in combating skin cell cancer. It wasn't cheap, but I ordered a bottle and the spot is now so small that my family thought the dermatologist (whose appointment I cancelled) actually treated it.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.