MD discusses effects of Obamacare
Tuesday night’s win in the presidential contest for President Obama was a win for ObamaCare, the president’s signature legislation from his first term. ObamaCare will now continue to be implemented.
This future means that we will continue to be faced with rising insurance premiums, as our current insurance expands to cover all patients regardless of pre-existing condition, age, or how many times they’ve already used the policy.
Insurance will continue to follow a one-size-fits all model, where it is easy to overuse but may not cover our latest expensive technology which offer more personalized solutions.
Federal regulations in the form of Medicare’s Independent Payment Advisory Board as well as ObamaCare’s many other committees will restrict my choices for my patients. I will have more patients with more red tape and less time to spend with them.
Since ObamaCare does not effectively address the doctor shortage, you will see more nurse practitioners and physicians assistants, who are quite competent, but have different training than I have treating patients.
My patients who gain a new insurance card may find that it doesn’t buy them the care they were expecting.
Medical care will be shifted more and more to the hospital and medical center, which are more equipped to preserve their bottom line profits despite increasing federal regulations.
Accountable Care Organizations under the Affordable Care Act will focus more on quality of care as opposed to fee for service, which large groups and medical centers are more equipped to implement.
Doctors will cherry-pick their patients, staying away from those who are too sick to allow them to apply for financial incentives.
ObamaCare can only afford to extend health insurance entitlements to more people through increased taxes or penalties (payroll tax for Medicare, individual and business mandates, tax on medical devices, etc.).
If the current economic climate continues, small businesses will be reluctant to add more employees and large businesses will prefer to pay the ObamaCare penalty than pay the increasing premiums.
More and more people will get their health insurances at the state exchanges, where taxes pay for federal stipends in states which have created their own exchanges.
There will be a disparity of services provided depending on your state. Medicaid expansion offered to 16 million more people will also vary depending on whether your state can afford to implement it or not. Medicaid lacks sufficient providers or networks to provide care, and the expansion makes this problem far worse.
President Obama’s victory on election night is not a victory for health care, though it may be a narrow one for health insurance companies who gain more customers.
Prices will continue to rise and access to actual care will decline in an already overcrowded system.
Biotech companies and drug companies may feel that the climate is no longer ripe for innovation.
Hospitals and other health care providers will continue to struggle amid shrinking reimbursements.
Bottom line: my patients who gain a new insurance card may find that it doesn’t buy them the care they were expecting.
Marc Siegel MD is an associate professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center. He is a member of the Fox News Medical A Team and author of The Inner Pulse: Unlocking the Secret Code of Sickness and Health.
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