A Shortage Of Doctors: Ya Don’t Say… And The Other Unintended Consequences Of Obamacare

Tuesday, April 13th, 2010

The Wall Street Journal shares this inevitable news:

The new federal health-care law has raised the stakes for hospitals and schools already scrambling to train more doctors.

Experts warn there won’t be enough doctors to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges.

That shortfall is predicted despite a push by teaching hospitals and medical schools to boost the number of U.S. doctors, which now totals about 954,000.

The greatest demand will be for primary-care physicians. These general practitioners, internists, family physicians and pediatricians will have a larger role under the new law, coordinating care for each patient.

The U.S. has 352,908 primary-care doctors now, and the college association estimates that 45,000 more will be needed by 2020. But the number of medical-school students entering family medicine fell more than a quarter between 2002 and 2007.

A shortage of primary-care and other physicians could mean more-limited access to health care and longer wait times for patients.

The whole point of health care reform was too feel better–not you, or your health–but liberal politicians.

It wasn’t to improve health care treatment.

It wasn’t to reduce costs.

It wasn’t even to get more people under care.

Wait, what? That’s right. More people will be insured, but patients will receive less care at more cost. It’s just logical. The new health care system creates a gatekeeper system that will eliminate individual choice and drive up costs. So, a person thinks something is wrong with his prostate–he goes directly to a proctologist. That saves 1. wait time 2. cost (no double doctor fees) and 3. diagnosis time.

But not now.

Oh no! Now, a patient must wait to get into an overburdened primary care physician, get a referral and then get into another physician. A patient will be dead by the time he gets diagnosed.

The inevitable response?

Cash-only doctors. Some doctors won’t accept this new insurance and work outside the system. So, people will pay into the health service, hate the waits and then, go pay cash for good care.

The rich will have good care while subsidizing everyone else. The middle class will be caught in a jam because the taxes will be so egregious they can’t afford anything, never mind a quick diagnosis. So they will be caught in government-mandated substandard care.

And the poor, who don’t pay into the system, will still misuse the system because they still won’t take care of themselves. And Medicare and Medicaid could have been expanded to help them as is.

But noooo. An overhaul had to happen. The government had to control health care.

If this diseased legislation doesn’t get revoked, America is going to go down the road of all disastrous socialized countries: chronic unemployment, disheartened and downwardly mobile middle class and an elite aristocracy for whom policy doesn’t matter.

In the liberal world that’s called utopia.

And by the way, a small board will decide what does and does not get covered under Obamacare. So, yes, death sentences will be handed down by the government. That too, is inevitable.

Health Care Reform: About Doctors

Wednesday, March 17th, 2010

My last post focused on jobs generally. Now, what about Doctors? Everyone wants to know about doctors because it’s already tough to get a doctor if you’re on Medicaid or Medicare.

According to the New England Journal of Medicine, it’s going to get worse:

Physician Support of Health Reform in General
• 62.7% of physicians feel that health reform is needed but should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in legislation. [NOTE: I think this reflects the American public, too. No one is saying to do nothing. This bill is just not the “something” that needs to be done.]
• 28.7% of physicians are in favor of a public option.
• 3.6% of physicians prefer the “status quo” and feel that the U.S. health care system is best “as is.

Health Reform and Primary Care Physicians
• 46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine.

Health Reform, Public Option, and Practice Revenue/Physician Income
• 41% of physicians feel that income and practice revenue will “decline or worsen dramatically” with a public option.
• 30% feel income will “decline or worsen somewhat” with a public option.
• 9% feel income will “improve somewhat” with a public option, and 0.8% feel income will “improve dramatically” with a public option.

Health Reform, Public Option, and Physician Supply
• 72% of physicians feel that a public option would have a negative impact on physician supply, with 45% feeling it will “decline or worsen dramatically” and 27% predicting it will “decline or worsen somewhat. [NOTE: This is the part that is most concerning. What will then happen is that the United States will recruit less-qualified drones to fill the jobs. As the role of physician becomes commoditized, the person seeking that job will change.]
• 24% of physicians think they will try to retire early if a public option is implemented.
• 21% of physicians would try to leave medicine if a public option is implemented, even if not near retirement age at the time.

Health Reform and Recommending Medicine to Others as a Career
• 36% of physicians would not recommend medicine as a career, regardless of health reform.
• 27% would recommend medicine as a career but not if health reform passes.
• 25% of physicians would recommend medicine as a career regardless of health reform.
• 12% would not recommend medicine as a career now but feel that they would recommend it as a career if health reform passes

Source: The Medicus Firm “Physician Survey: Health Reform’s Impact on Physician Supply and Quality of Medical Care,”
The Medicus Firm, www.TheMedicusFirm.com

This does NOT bode well for the future of American medicine. More importantly, it harms the care Americans will receive.

By the way, Democrats know this. This bill is NOT about health care. It’s about transitioning costs away from the unions and the ballooning aging Boomer population to the younger, healthier people.

Health care reform is a tax plan.

Blood Tests By Cops? No. Twitter By Surgeons? Yes.

Monday, September 14th, 2009

A tale of two technologies. I don’t care that blood draws by cops help stop drunk driving, I don’t want a cop near a needle, period. Too many things can go wrong.

What about surgeons giving updates from the surgery? Coolness. Doctors take turns, nurses help open and close, and in between a surgeon can update on progress. Since I’ve been in the waiting room too many times to note, I must say that the waiting…often hours…is just so stress inducing. Being told that the first phase is done and went well or there has been some trouble as the tumor was more invasive than expected, might or might not be welcome news, but the worst part is not knowing.

Forced Abortions: Majority Of American Women Feel Coerced To Abort

Tuesday, September 8th, 2009

Many women experience pressure, abuse, and coercion when faced with a surprise pregnancy. This is bearing out with research reported by LifeNews:

Elliot Institute director David Reardon, co-authored a Medical Science Monitor study of American and Russian women with the 64 percent figure.

His new report, Forced Abortion in America, documents cases of violence against women who refused to have an abortion.

It also highlights cases like the one in Maine, which saw a couple charged with abducting their pregnant daughter in an attempt to force her to have an abortion, and another in Georgia, where a woman forced her pregnant daughter to drink turpentine to cause an abortion.

Reardon says the cases are just part of an epidemic of coerced and forced abortions in the U.S.

Reardon said that cases of women being pressured, threatened, or subjected to violence if they refuse to abort are not unusual.

He pointed out that studies have shown that homicide is the leading killer of pregnant women in the U.S. and that women in abusive relationships are at risk for increased violence during pregnancy.

“In many of the cases documented for our ‘Forced Abortion in America’ report, police and witnesses reported that acts of violence and murder took place after the woman refused to abort or because the attacker didn’t want the pregnancy,” he said in a statement LifeNews.com received.

“Even if a woman isn’t physically threatened, she often faces intense pressure, abandonment, lack of support, or emotional blackmail if she doesn’t abort. While abortion is often described as a ‘choice,’ women who’ve been there tell a very different story,” he added.

It has been the rare woman in my practice who sought the abortion and feels no guilt years later. Most women were either pressured to abort or chose the abortion and feel guilt later and remorse later. It is the rare woman who truly “chose”. It is a rarer woman who has no regret over her choice.

A Reality Check For Whitehouse.gov/realitycheck

Tuesday, August 11th, 2009

Two separate problems are inherent with www.whitehouse.gov/realitycheck. One, it’s pure Obama propaganda. Two, it’s funded by you, the taxpayer.

In my American Issues Project column today, I take on the reality of the six narratives the President puts forward via his proxies in videos there. I’ll share two “reality checks” here, but I hope you’ll read the whole thing.

The topic of the day seems to be “death panels”. President Obama and his representatives insist that utilitarian and actuarial arguments will have nothing to do with decisions. People are skeptical for very good reasons:

“The ‘euthanasia’ distortion on help for families” Related to the rationing concern, euthanasia is like unto it–rationing begets denial of care. Containing costs, when administrative costs are out of control (a problem with all bureaucracies), means denying high-cost items. Since the majority of health care costs come at the end of life, the bureaucracy is going to look at limiting end-of-life care. This is just common sense.

So, what that will mean is this: Grandma might have a two weeks left, but if parental nutrition (IV nutrition) was withheld, she would die in three days, instead. This results in enormous cost savings. It may also deprive the family of her last waking moments. It may deprive the family of time to say last good-byes, etc. These are intangibles. Life and death and the choices around them are incredibly personal. The government board who decides such things will, by cost-cutting necessity, insert themselves and be making moral (or immoral, depending on one’s perspective) decisions. This is a valid concern.

There are five other myths over there including talking about current Medicare recipients, veterans benefits paying for care, rationing, keeping your own insurance, etc. The most snort-worthy is that government run health care is good for small business:

“Reform will benefit small business – not burden it” This statement is just laugh-out-loud worthy. The best treatment of this subject is by Patty Briguglio, small business owner. I urge you to read her whole article. Here’s a snippet:

The president plans to use revenue from these higher taxes to pay for the $634 billion health care reform reserve fund. The administration’s new health care mandate would require employers like me either to offer health insurance to our employees or to pay an unspecified percentage of our payroll toward the cost of a national plan. Right now, I give each of my employees an allowance toward health care — essentially, they obtain the health insurance plan of their choice, and I reimburse them. In most cases, this allowance covers 100 percent of the cost of their insurance. Some of my employees worry that under the administration’s new mandate, they would not be allowed to keep their current insurance plans.

So, the plan will tax small businesses, but give them a tax credit. Guess what happens when costs sky-rocket? That’s right. Buh-bye to the tax credit. Furthermore, small business, already struggling with cash flow, decreased credit availability, a shrinking market and increased overhead proportional to profits, will have to pay more taxes? This is an economy killer and small business people know this. So does the administration.

Again, please go read the whole thing. As a taxpayer, you should be very concerned that the Obama administration is using the power of their pulpit to give bad information this way.

Notably Absent From The Presidents Address: The Scourge Of Trial Lawyers

Thursday, July 23rd, 2009

In the 1960’s, the popular surgery was to remove tonsils (sometimes, as in my mom’s case, it was even necessary). In the 1970’s, the popular surgery was to have perfectly functioning ovaries and uteri removed. In the 1980’s, the popular surgery was to have a knee “scoped”. And, at one time, bloodletting and frontal lobotomies were also en vogue. Clearly, medicine is not always evidence based. Often, doctors are slow to change their prejudices. Doctors are not pure-hearted creatures unmotivated by such base things as financial reward.

All that being said, the real scourge to modern American medicine is not doctors unnecessarily removing tonsils, as President Obama implied during his press conference. The real scourge lurks behind every patient and hangs over every procedure and is terrifying to doctors because their existence can be a living nightmare during one small mistake. The real scourge, trial lawyers, drive most unnecessary procedures these days and President Obama said not one word about them.

Duane Lester writes about this important topic today. He says:

It’s interesting that President Obama discusses unnecessary operations as one of the causes of high health care costs. Do you know what the most often performed operation is in the United States? With heart disease being the number one killer in America, you might think it would be related to that, perhaps bypass surgery or angioplasty.

It’s cesarean section. In 1965, only 4.5 percent of children were delivered via c-section. Today, 31 percent are. That’s a huge increase for a procedure that was once reserved to emergency situations. And as the Los Angeles Times notes, it has resulted in “an explosion in medical bills, an increase in complications — and a reconsideration of the cesarean as a sometimes unnecessary risk.”

What is the reason for the increase? Is it greedy doctors looking for a new summer home? No, it’s something far worse.

John Edwards.

Please go read the whole thing and then come back. It is not hyperbole to indict John Edwards for this problem. He started the problem in the case of C-sections. But for every one John Edwards, there’s ten other trial lawyers suing doctors for some other malady. You see the advertisements on TV. “Have you been wronged? Did you take this drug? Are you experiencing THIS SYMPTOM?!! Call NOW! And get what is rightfully yours!”

Every medicine, procedure, surgery and consultation a doctor must consider from a legal standpoint. Does malpractice occur? Yes. Do unnecessary surgeries and procedures occur? Absolutely. But oftentimes, doctors are doing procedures and taking actions to avoid a lawsuit–that might mean ordering extra tests to “be sure”, doing a procedure “just in case” and performing a surgery “so we don’t miss something.”

In Texas, where the state passed Tort reform, malpractice insurance has dropped and doctors have flooded into the state. That’s a good thing because the population has increased dramatically so Texans need more doctors.

Some patients have been wronged by a doctor’s negligence, so malpractice insurance will be a continued fact of life. And lawyers will need to represent the patient.

Still, lawsuits force doctors to make medical choices that often are more expensive and unnecessary than they otherwise would. And that is the hidden cost of health care the President didn’t talk about.

Talking Health Care: Governtment Run or Universal Coverage…Likely It’s The Same

Monday, June 1st, 2009

Are you guys sick of the topic yet?

Well, here’s where I agree with Barack Obama, it’s happening this year or never. I’m voting for never. The reason why there is so much emphasis on getting this done is because should the economy pick up and people start being employed again, the fear and discomfort will ease and people will get more rational again and remember that America is already in debt up to it’s eyeballs and can’t afford to pay for everyone’s health care.

My biggest concern with Government Run health care is that the government will run it and run you. That is, your life will be controlled from cradle to grave. You will eat a certain way…or else. You will do certain things…or else. And the government will have every motivation to force you down a path.

Ultimately, this is a civil liberties issue. Some people say that not having health care for all is shameful in such a wealthy country. Shameful is the notion of a bureaucrat deciding whether you live or die based on the metrics of a chart. That’s shameful. And that would be our future. It is a future I don’t want to see.

Just look at the big government, totalitarian groups that are for this mess. It should give you an idea of what you’d have to look forward to in the future.

Some are saying that Universal Health Care is likely to pass. Doesn’t this sound good?

But I want to remind everyone of something: Congress regulated Freddie Mac and Fanny Mae. Congress gave GM $62 BILLION and now, GM is going bankrupt which is what they should have done months ago. That’s your tax dollars. The United States government has shown itself to be a poor steward of our resources.

Why should we trust them with health care?

I will be talking about Health Care issues this week on RFCradio.com tonight at 10 Eastern, 9 Central and will chat with you, too, and welcome your questions.

Government-Run Health Care & Your Right To Be Chubby

Wednesday, April 29th, 2009

How fat is too fat? Don’t worry, the government will soon have an answer to that question and your health care will be determined by that answer. From TheHill:

Health reform radicals howl when it’s pointed out that the board’s true mission is to determine which treatments are “cost-effective,” claiming that language in the law prohibits them from making specific recommendations based on cost. But that’s just smoke and mirrors designed to distract Americans from the truth: the board controls a $1.1 billion budget and will recommend how to direct future research dollars. Clearly, cost-effectiveness is the primary metric the board will measure.

The legal language creating this ominous national board was buried in the stimulus package details that — we now know — nobody read. Four hundred million dollars went to the Department of Health and Human Services, another $400 million to the National Institutes of Health, and finally $300 million more to yet another nest of bureaucrats you’ve never heard of called the Agency for Health Care Research and Quality. In all, $1.1 billion has been budgeted for “comparative effectiveness research.”

An interesting stand-off will be forced should government-run health care be pushed through by the ever stronger Democrat party: People schooled in “anything goes” and defined by civil rights, will be in the position of having to submit to the government telling them what they can do regarding their most personal habits. Already, these folks are angry. Already, people don’t want this. A new civil rights group decries discrimination and have already suffered at the hands of doctors:

There are no U.S. laws prohibiting weight discrimination, and only one state, Michigan, has an anti-weight bias law. Legislatures in Massachusetts and Nevada have taken up size-bias bills, but similar efforts have failed in recent years.

Weight discrimination is pervasive, said Rebecca Puhl, director of research at Yale University’s Rudd Center for Food Policy and Obesity.

An “obesity wage penalty” — larger employees getting paid less regardless of job performance — is widespread, and research shows overweight people are less likely to land a job or be promoted than a non-obese worker, she said.

“We do need to fight obesity, but not obese people,” said Puhl. “Individuals … who are discriminated against because of their weight are more likely to engage in unhealthy eating behaviors and avoidance of physical activity.”

Anecdotal evidence also suggests overweight people avoid trips to the doctor out of fear of being mocked.

According to NAAFA, about 70 percent of overweight and obese women have experienced bias from doctors. Others complain of being turned down by health-insurance companies.

Doctors are frustrated by patients complaining of wholly preventable health problems. Patients feel embarrassed and judged by their doctors so don’t get the health care they need.

Government run health care will increase the tension in the doctor-patient relationship–when the patient ever gets to see the doctor.

Cross-posted at RightWingNews

Kathleen Sebelius Will Let You Die

Tuesday, April 21st, 2009

And why not? You, old person, do not fall within the parameters of the rules for saving. Neither do you, small child with degenerative disease. Nor do you, Lance Armstrong with your 10% chance.

Suck. It. Up.

And remember, you’re saving money for the people who are worth saving. From Matt Lewis:

Reading the Associated Press report, one would assume Tiller is the only problem, yet he barely draws a mention in Kyl’s press release on Sebelius. Instead, Kyl (who voted against Sebelius) singled out Sebelus’ views on “comparative effectiveness research”.

In English, that translates roughly as research to determine who is worth health care and who we should just let die. [Emphasis added]

Essentially, when you factor “comparative effectiveness” into medical decisions, it means that those decisions have to be made at least partially based on cost rather than the best interest of the patient.

She should receive no Republican support but she’s got two Senators in her corner. And some wonder why the Republican brand is crap.

Wizbang: Kim Priestap

Tuesday, March 17th, 2009

Why Does Obama Hate The Military?
While he wants to socialize medicine for everyone else, he wants vets to pay for theirs. Hmmm…