Even Americans with private health insurance are sometimes having difficulty finding doctors who will treat them. As The New York Times reported last fall, “Efforts by insurers to rein in health care costs by holding down physician fees – especially for primary care doctors, who play a critical role in health care though they are among the lowest paid doctors – appear to be accelerating the trend.”
The Times went on to report that a comprehensive survey of doctors nationwide determined over half planned to undergo steps that would reduce access of patients to their services in coming years. Of these, some planned to begin requiring patients to pay annual fees to retain access to their services.
Do you remember when health insurance pretty much assured you’d be at the front of the line?
Well, that’s not always the case anymore.
Doctors blame the health insurers, arguing that insurance companies simply are not paying doctors their due, and in some cases making it impossible for medical practitioners to earn a fair living.
The Affordable Care Act
The Affordable Care Act (ACA) of 2010 aims to reduce the number of Americans who have no health insurance from the current 40 million-plus to a much smaller number.
Here are a few ways that is supposed to happen:
1. The ACA will prohibit insurance companies from denying anyone health coverage due to preexisting conditions.
2. Companies with over 50 employees will be required to offer health insurance to their workers by January of next year.
3. Under the ACA, all 50 states are required to establish health insurance exchanges designed, as healthcare.gov puts it, to provide uninsured Americans the opportunity to “shop for health insurance that fits you, with low-cost and even zero premium plans for those whose income qualifies.” All states are required to have active Health Exchanges by the start of 2014, and individuals will be able to enroll starting in October of this year.
These requirements are expected to decrease the number of uninsured Americans significantly. But equally important to supporters of the Obama administration’s efforts to extend health coverage to a much larger number of Americans are provisions of the ACA requiring most Americans to have health insurance by Jan. 1 of next year.
Most individuals choosing to remain uninsured despite increased availability of insurance coverage will be assessed a penalty. Although some individuals will surely take their chances and remain uninsured despite threats of penalties, it is generally accepted-even by people who support an individual’s right to go uninsured and who oppose governmental pressure on Americans to enroll in health plans-that the ACA will lower the number of uninsured Americans significantly.
Unfortunately, many people newly enrolled in health plans at the start of next year are likely to learn what many currently enrollees are finding out-that having health insurance is no longer a guarantee that you’ll get all the medical attention you need. In some cases, it’s not even a guarantee that a doctor will see you.
And that’s the context in which we have to examine why so many doctors are leaving Medicare.
Medicare and Doctors
Provisions of the Affordable Care Act call for cuts in Medicare spending totaling over $700 billion.
If that number sounds a little abstract, look at it this way. That’s over $14,000 for each person currently on Medicare.
According to Pres. Obama, those cuts will not negatively impact Medicare recipients. During last year’s presidential candidate debates, the President declared the cuts resulted in part from “making sure we weren’t overpaying providers Medicare Supplement Plan G.” The President also defended the cuts by saying, “We were actually able to lower prescription drug costs for seniors by an average of $600, and we were also able to make a significant dent in providing them the kind of preventive care that will ultimately save money throughout the system.”
Opponent Mitt Romney and many of his supporters saw the cuts in a different light. According to Romney, the ACA cuts to Medicare would impact Medicare recipients negatively by limiting their treatment options. “Some 15 percent of hospitals and nursing homes say they won’t take any more Medicare patients,” Romney said. “We also have 50 percent of doctors who say they won’t take Medicare patients.”
Earlier in the campaign, Romney’s running mate Paul Ryan had characterized the cuts to Medicare as the result of shortcomings of the Affordable Care Act. Suggesting that the ACA was not financially sound, Ryan said, “The planners in Washington didn’t have enough money. They needed more. They needed hundreds of billions more, so they just took it all away from Medicare. $716 billion funneled out of Medicare by Pres. Obama.”