Combs Spouts Off

Remember that Presidential promise, “If you like your doctor, you can keep your doctor”? Well, if you’re a Medicare patient, that may not be true for long. Congress hasn’t acted to rescind a 21% reimbursement cut that took effect last week (they removed the so-called “doc fix” from the Obamacare bill in order to maintain the fiction that it would reduce health care spending). Since Medicare reimbursements averaged only 78% of private insurance payments before the 21% cut, more and more doctors are refusing to take new Medicare patients or opting out of Medicare entirely:

The number of U.S. doctors refusing new Medicare patients has increased to record levels as low government payment rates force them out, statistics show.

USA Today notes the doctors’ exodus comes just six months before millions of baby boomers begin enrolling in the federal government healthcare program.

“Physicians are saying, ‘I can’t afford to keep losing money,'” said Lori Heim, president of the American Academy of Family Physicians.

AAFP reports 13 percent of doctors who responded to a survey said they didn’t participate in Medicare last year, up from 8 percent in 2008 and 6 percent in 2004.

…

The American Medical Association said 17 percent of more than 9,000 doctors surveyed said they restrict the number of Medicare cases, and the rate rises to 31 percent for primary care physicians.

Shortages of primary care physicians already alarm many experts, and the seniors group AARP says record numbers of doctors refusing Medicare will make matters worse.

So “you can keep your doctor” is just as false as “you can keep your health care plan” (emphasis added):

Employers would lose grandfathered status if they switch insurance companies — unless the plan is covered by a union contract or the employer pays claims out of its own funds and uses the insurer only to administer the plan.

It isn’t clear how much the restrictions on co-payments and deductibles will save consumers, because health plans can still raise premiums. The rules issued Monday say plans would relinquish grandfathered status if they reduce the percentage of the premium they pay by more than five percentage points. The broader health-care law includes checks on unreasonable increases, which have not been defined.

The administration estimated that by 2013, health plans covering as few as 39 percent and as many as 69 percent of employees could lose protected status. For small employers, the total could be as high as 80 percent; for large ones, it could reach 64 percent.

The picture isn’t actually as rosy as the Washington Post tries to paint it. The hundreds of pages of restrictions and regulations in the Obamacare bill, coupled with the implementation rules announced last week, coupled with the rules yet to come, will ensure that existing “grandfathered” plans become unprofitable and untenable, and they will go away. That, as I’ve argued before (for instance, here and here), is part of their plan to force everyone into a single-payer system.

If some insurance companies try to maintain their existing plans by emulating Medicare — cutting reimbursements for health care providers — they’ll find themselves between the same rock and hard place that Medicare is now in: providers will simply stop providing under those conditions. Unless the government steps in and forces them to do so.

And if the government forces health care providers to provide their services against their will — well, I recall something Ayn Rand said about socialized medicine decades ago (I’m paraphrasing): Do you want your life in the hands of a doctor who resents being forced to treat you? Do you want your life in the hands of a doctor who doesn’t?

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