Politics & Policy

Unhappy Birthday for Obamacare

Doctors are fleeing their profession, and patients like the reform less and less.

Obamacare marked its third birthday last Saturday.

It is now even less popular than when it barely passed Congress in March 2010. The Kaiser Health Tracking Poll, which has always shown the highest support for Obamacare of any major poll, found that 46 percent of Americans approved it when it originally passed. Kaiser’s latest survey this month finds that only 37 percent approve. Breaking that down, only 18 percent of Republicans and 31 percent of independents have a favorable opinion of the health-care reform. Among Democrats, only 58 percent like Obamacare overall. By a margin of about 2 to 1, those who responded to the Kaiser poll believe that health-care costs will rise and the quality of health care will decline in coming years, exactly the opposite of what President Obama promised.

#ad#One reason is that Obamacare is likely to exacerbate a growing shortage of physicians, and people are starting to notice. More and more anecdotal evidence is piling up that patients can’t get in to see their doctors as quickly as they used to. The Association of American Medical Colleges predicts that the U.S. will be short 62,900 physicians by 2015 — only two years away — and as many as 140,000 by 2025. That latter number would represent a shortfall of 15 percent.

A new survey by the Deloitte Center for Health Solutions shows that one of the key reasons for the growing shortage is that unhappy doctors are leaving their careers early. Of the physicians whom Deloitte surveyed, 62 percent said it’s likely that many of their colleagues will abandon their practice in the next one to three years. Another 55 percent predict that their colleagues will cut back on practice hours and have less time to see patients.

It’s not hard to figure out why there’s so much discontent. Four in ten doctors reported to Deloitte that, from 2011 to 2012, their income fell. A full 40 percent of those whose income was cut blamed Obamacare. Nearly half of all doctors (51 percent) believe physicians’ incomes will fall dramatically in the next one to three years. In addition, doctors see little chance for positive reforms passing Congress. Only one in ten expect meaningful medical-liability reform to become law in the next one to three years. Only a quarter think Congress will change its practice of ratcheting down Medicare reimbursements.

The crackdown on Medicare reimbursements has meant that seniors have less access to doctors. A fifth of doctors overall and 31 percent of primary-care physicians are now limiting the number of new Medicare patients they accept. Those numbers are expected to grow as spending is squeezed on privately managed Medicare Advantage plans and other programs in order to pay for Obamacare’s expansion of health-care benefits to the uninsured. “Medicare patients are likely to have a tougher time seeing their doctors,” says Grace-Marie Turner, president of the Galen Institute, a health-care think tank. “Every day about 10,000 Americans turn 65. It’s estimated 25 million new Medicare recipients will be joining the program by the year 2020.”

#page#A glimpse into what bureaucratically controlled medicine will mean in the future comes from Massachusetts, which led the nation back in 2006 in implementing many of the provisions now enshrined in Obamacare. The program was pushed through a Democratic legislature and signed into law by then-governor Mitt Romney. In interviews, Romney has claimed that the state legislature has piled onto health-care providers additional mandates that he never envisioned. The template for these changes, however, was in the bill he signed into law.

The expansion of subsidized medical services to more Massachusetts residents, along with zero growth in the number of physicians available to patients, has produced inevitably unwelcome results. The Massachusetts Medical Society reported last August that only half of the state’s primary-care practices are now accepting new patients, down from 70 percent as recently as 2007. The average waiting time for a new-patient appointment with an internist is 44 days. It now takes an average of 45 days for a new patient to get an appointment with a family doctor.

#ad#Michael Murphy, a resident of Cambridge, told the Wall Street Journal in 2011 what the longer waiting times meant for him:

I had a doctor’s appointment which ended up being canceled because my doctor decided to stop practicing medicine in Massachusetts — my second doctor to do so in less than six months. However, his office couldn’t reschedule my appointment with another of their dozens of doctors because none were taking new patients. So instead they asked what prescriptions I needed and had a doctor I’d never met write them for me, and then told me to call back next month to see if any appointments were available. I may have health insurance, but that is not health care.

Skyrocketing insurance premiums, a slowdown in medical innovation, longer waiting times for appointments. Obviously, Obamacare isn’t solely to blame for the long-standing problems with American health care. But it clearly isn’t making matters better. Last week, 33 of the Senate’s 53 Democrats voted to repeal Obamacare’s 2.3 percent tax on medical-device makers, a levy that Senator Al Franken (D., Minn.) complained was hurting U.S. medicine: “The industry is being punished for its innovation and growth.”

If the only people being punished by Obamacare were medical-device manufacturers, we’d be lucky. The truth is, the biggest victims of Obamacare are the vast majority of the American people, and polls show that more and more of them are recognizing that unpleasant reality.

— John Fund is national-affairs columnist for NRO.

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