There is a looming, if not current, crisis in health care delivery in the United States involving a shortage of physicians. I have previously written about what I believe will be a two-tiered system of healthcare that will split patient’s care into those who will be seen in the single-payer government controlled system and those that will pay a fair price to be seen in a non-government controlled environment, free of any bureaucratic encumbering. What will inflame this situation even further, will be a critical shortage of physicians, such that those patients who are in the government-controlled group will have significant difficulty in accessing the care and face time with an actual doctor, regardless of whether they have insurance or not. So much for accessibility!
The situation will be worse in the emergency rooms. With the substantial reduction in Medicare and Medicaid physician payment, more and more doctors are opting out of the plans. As people who were not previously insured and who have chronic disease are now enrolled in Medicaid and other programs, they will have the sense that they now can seek care. The reality is that there will be no one to care for them, as doctors flee the government-funded entitlement programs owing to insufficient reimbursement to meet their ever-increasing overhead. The solution- why, go to the emergency room.
The completely inundated emergency rooms will not be equipped to handle the increased load so the waits will be extraordinarily long. When coupled with the influx of 18 million previously uninsured Americans making more than $50,000 a year, 10 million of whom make more than $75,000 a year, into physician’s offices, and fewer of those physicians at that, there will be a de facto rationing by waiting. What diagnoses will be missed? What cancer will not be caught in time? Who shall live and who shall die.
What then will we do about the shortage of physicians, particularly family practitioner and internists? Physician extenders will see us; people such as nurse practitioners and physician’s assistants. We will likely accept more and more foreign medical school graduates whose familiarity with our culture and the needs of our people will be a substantial initial handicap to their ability to give us the best overall care.
The question next begged is what about seeing a specialist if you have the government plan commonly known as Obamacare? With the number of patients now having insurance suddenly and dramatically increased by the mandate in the PPACA (Obamacare), there will be longer and longer waits to see specialists. One only has to look to Massachusetts to see the future of specialty care for all of us.
Calling Dr. Howard, Dr. Fine, Dr. Howard? Sorry, No answer. Please leave a message at the beep. If this is a true emergency, please hang up and dial 911.