Two-Tier Health Care
…About one-third of primary-care physicians and one-fourth of specialists have already completely closed their practices to Medicaid patients. Over 52% of physicians have already limited the access that Medicare patients have to their practices, or are planning to, according to a 2012 survey by Merritt Hawkins for the Physicians Foundation. More doctors than ever already refuse Medicaid and Medicare due to inadequate payments for care, and that trend will only accelerate as government lowers reimbursements.
…The American Academy of Private Physicians estimates that there are now about 4,400 concierge physicians, 30% more than last year. In a recent Merritt Hawkins survey, about 7% to 10% of physicians planned to transition to concierge or cash-only practices in the next one to three years… (WSJ)
This really illustrates one of the fundamental problems with ACA. A fat lot of good “coverage” does if you can’t actually use it receive affordable medical care.
Is it even coverage?
“More doctors than ever already refuse Medicaid and Medicare due to inadequate payments for care, and that trend will only accelerate as government lowers reimbursements.”
But some previously posted articles also said that doctors get much money from the Medicaid every year. Is this a kind of contradiction?
I don’t know what articles those were, but its pretty obvious that doctors are going to be increasingly less incentivized to accept anyone on government-run health coverage.
You can’t blame them. Imagine someone tried to pay you for a service that you don’t even break even when you provide that service.
If this is a poor justification for doctor’s overcharging their patients,I would posit this is why healthcare is too expensive to begin with. Doctors are trying to break the cost curve which is going down.
When ACO’s are fully up and running these doctors will be left behind due to their greed.
So now we will just have healthcare for the poor and healthcare for the wealthy. It was obvious that it was going to move this way soon enough.
ObamaCare: Reducing both the access and quality of healthcare since 2014.
“…only the lower and middle classes in America will suffer the full consequences of ObamaCare.”
I feel like people have been shouting this the whole time.
“In a recent Merritt Hawkins survey, about 7% to 10% of physicians planned to transition to concierge or cash-only practices in the next one to three years.”
Well the clinics following this model have started to see success. However, good luck getting an appointment, I bet that’s where everyone goes.
This is a little off-topic, but the United States already has a multi-tiered health care system. For instance, Bill Gates and Warren Buffet can get a level of care far better than most of us. A Medicaid enrollees or an uninsured person seeking care at a community health center gets a level far lower than billionaires. There is nothing inherently wrong with that. In fact, one problem with our health care system is it’s too rigid and inflexible to respond to differences in demand. Another way of saying this is that it has too few tiers (not too many).
Take automobiles for example. There are numerous different makes and models out there. There are models that are expensive and only hold two people. There are big SUVs that will haul a baseball team. Within each class, there are numerous brands to choose from.
This is hardly the case with health care. In health care, the most common way to access the health care system is using health insurance and seeing a medical doctor. We regulate away the options for poor people and low income people who may not want to access our health care system in this way. We don’t allow patients to talk to an India doctor on the phone or by email (at least we don’t allow an Indian doctor to actually practice medicine by phone). We don’t allow a health mart to practice medicine employing a mix of physicians, pharmacists and nurses (i.e. only a licensed physician can practice medicine). We limit the ability of patients to access medications to those available over the counter or those with a doctors prescription. We don’t really have any other avenues.
Completely agree with you Devon. Our society is built on inequality. For everything we do, buy or get there are different levels and we choose those that correspond to our own social status. People don’t complain about what car they drive, what clothing they wear, what they eat. Everything is differentiated, so why differentiating health is so bad, especially when it can be designed to better address the needs of the people.
Obamacare made the government stand in the awkward position, making the healthcare worse than it was. It also creates more inequality when the program was intended to reduce it. The government should either stand back and let the market work, or become fully involved as in the UK.