The Doctor Won’t Be Seeing You

by Charles Katebi

Obamacare's supporters seem to believe that if you give patients insurance, doctors will treat them. But greater access to health insurance doesn't mean greater access to healthcare. As patients scour Obamacare's insurance exchange for coverage, they're finding fewer doctors accepting Obamacare's insurance as payment. And those that can are spending less time with patients, possibly compromising their care.

Doctors often reject Obamacare patients because of expensive new regulations the law imposes on insurers. Insurers must to cover an array of "Essential Health Benefits" for every policy holder. In addition, they required to charge everyone the same premium regardless of their health status. A study by McKinsey & Co. found that insurers lost $2.5 billion in 2013 because of Obamacare.

To cope with these costly mandates, insurers are cutting payments to doctors. To keep doctors on board, insurers promise them more patients in exchange for lower per-patient fees. How is this scheme working?

A survey by the physician staffing company, Locum Tennans, found that the biggest challenges doctors face under Obamacare are "increased patient visits with decreased reimbursement and increased paperwork, meaning less time with the patient."

Welcome to socialized medicine.

Obamacare's changes are steadily curtailing patient access to medical care. Many doctors would rather turn away Obamacare-insured patients than accept these low fees. A 2014 survey by the Medical Group Management Association, estimated as many as a quarter of practicing doctors are rejecting Obamacare insurance plans for pay.

Alan Miller, CEO of the hospital group Universal Health Services, which owns the Wyoming Behavioral Institute in Casper, has also noticed doctors opting out of Obamacare because of lower insurance reimbursements. On CNBC, he said:

"They get a better reimbursement when they take care of people that have insurance through their employer. The doctors get reluctant to schedule appointments [with patients who have Obamacare]."

This doctor shortage is only going to get worse as more physicians hang up their lab coats over the next several years. According to the Association of American Medical Colleges, one third of practicing physicians are over the age of 55 and plan to retire by 2020.

Marivern Eastern, assistant director of the University of Wyoming's College of Health Sciences, said in UW's August newsletter that Wyoming will be hit particularly hard by the paucity of providers. "Wyoming is facing a critical shortage of healthcare workers. The shortage will worsen as the baby boomer generation ages."

The doctors that remain in Obamacare-provider networks will have less time than ever to care for new patients. The average US physician cares for 2,300 patients already, according to a survey in the Journal of General Internal Magazine. However, an article published in Annals of Family Medicine recommends patient panels no larger than 1000.

Doctors simply don't have enough time to care for so many patients. A doctor with 2,500 patients would theoretically have to work 21.7 hours every day for a year to provide all of their recommended acute, chronic, and preventive care, according to the same article in Annals of Family Medicine.

Physicians require ample time to properly diagnose and treat their patients. When they take on too many patients, their time is limited, and patient care suffers. Physicians on average spend just 15 minutes with every patient. As a result, patients receive only half of their recommended chronic and preventive care.

Obamacare's cheerleaders measure the law's success by how many patients it covers. Sadly, few if any doctors can afford to treat individuals with Obamacare insurance. And the ones that can are spending less time with patients.