Doctor shortages will limit access

Published on Thursday, 17 April 2014 22:36 - Written by

One aspect of the Affordable Care Act is looming even as the Obama administration puts off deadline after deadline. Nothing in the massive law will answer the doctor shortage many parts of the nation are beginning to see. One reason is that when Obamacare was being formulated, medical malpractice reform was taken off the table.

“Proponents of the Affordable Care Act (ACA) insist that the law will extend health insurance to millions, expand access to health care and improve Americans’ overall health,” writes Joel Zinberg in City Journal, a public policy magazine. “But … having health insurance is not the same thing as getting good health care, or any health care. In fact, it doesn’t matter how many Americans obtain insurance under the ACA. Most will have difficulty finding a physician.”

We’ve known for years we’ve had a doctor shortage — and that one big reason cited by doctors themselves is the onerous burdens placed on their profession by the federal government. With the draconian new rules imposed by Obamacare, the vast majority of physicians now say they’ve considered quitting.

“Eighty-three percent of American physicians have considered leaving their practices over President Barack Obama’s health care reform law, according to a survey released by the Doctor Patient Medical Association,” the Daily Caller reported last year. “The DPMA, a non-partisan association of doctors and patients, surveyed a random selection of 699 doctors nationwide. The survey found that the majority have thought about bailing out of their careers over the legislation.”

Even if not a single doctor quits, the U.S. will face a shortage of at least 90,000 doctors by 2020, the government estimates.

Five years after that, the shortage will be 130,000.

Even the most optimistic policy makers are worried about this.

“I don’t think there’s going to be a shortage of doctors, and I’ve written about that with Zeke Emanuel, but I think there’s going to be relative shortages of doctors depending on what insurance scheme you’re in,” says health care reporter Charles Ornstein, writing in Pacific Standard magazine. “It could very well feel like there’s a shortage of doctors to you because your plan does not include a lot of specialists or even pediatricians. That’s what we’re seeing.”

Actually, what we’re seeing is more and more doctors declining to accept new Medicaid patients — and remember, a big part of Obamacare is the expansion of Medicaid.

“Many people will not be able to see the physicians who have treated them for years, use facilities providing the most appropriate treatment, or access care within a reasonable time and distance from their homes,” says Zinberg. “Some specialty hospitals have been excluded from all exchange plans.”

Malpractice reform should have been a part of the Affordable Care Act — seeing as how lawsuits are a substantial part of what makes health care so unaffordable.

Malpractice insurance rates rising while Medicaid payments decrease has the effect of driving out doctors. Some drop Medicaid patients; some leave the profession entirely.

But malpractice reform wasn’t part of the ACA. That’s an omission that Congress should remedy.