Obamacare: Storm Coming

[Geee]

National Review:

There may be a debate over whether Obamacare’s individual mandate is a penalty or a tax, but there is no debate among doctors and their patients about the fact that Obamacare will be bad for America’s health.

The climate in my medical office is changing; my patients sense that a storm is coming. They are worried, and there is little I can do to reassure them. They are used to my office manager getting approvals for the CT scans, mammograms, PSAs, and MRIs I order, and they realize that many of these tests will no longer be covered by insurance once Obamacare’s committees — which look at so-called comparative-effectiveness research and review current guidelines — are through with them.

Last week, with the Fourth of July looming, I was able to get a quick CT scan to rule out appendicitis for one patient, and an ultrasound of the legs to quickly diagnose a blood clot for another. Tests like these — ordered solely on the basis of my medical intuition – may not be possible in a few years. Since in both cases the symptoms weren’t “textbook,” I would probably have had to appeal to some Kafkaesque committee, wasting precious time; in an extreme instance, this could even cost a patient his or her life.

My patients know that their premiums will be going up and that, paradoxically, they will be receiving less service for their money. This is what happens when more people enter the system and are covered with easy-to-overuse insurance. Patients who overuse services will ultimately crowd out legitimate use for the group, as more regulations are imposed by both public and private insurers to preserve their bottom lines. Unfortunately, this process jeopardizes the art of medicine and real medical treatments, as doctors are pressured to conform to guidelines and insurers refuse to cover creative solutions. Obamacare caters to the worried well by allowing anyone to use the insurance, whether he or she is sick or not, with lower co-pays and deductibles and therefore no incentive against overuse. My patients also realize that I will be paid less for seeing them — first by Medicare and Medicaid, and then the private insurers will follow suit. Patients anticipate longer waits in my office and less time to spend with me. No one is asking me any more when I will change my office carpet or paint the peeling walls.