What a doctor knows about ObamaCare

Dr. Marc Siegel
Fox News
March 30, 2012

At the heart of the multi-headed abominable creature known as Affordable Care Act aka ObamaCare, there resides a singular deceit. It is too easy for lawyers and even U.S. Supreme Court Justices to miss this deceit in the process of arguing abstractions, but I and other doctors experience this reality every day our offices:

Insurance does not equal care. One patient’s needs can get in the way of another’s needs. My waiting room is like so many others in America, and when it is clogged with several patients with low-paying highly-regulated insurance, the waiting time goes up and the access to quality medical care goes down.

With all due respect to Supreme Court Justice Sonia Sotomayor, though it is true that everyone will get sick and need health care eventually, it is not true that health insurance automatically provides you with that care.

I can tell you as a practicing physician that the regulations and restrictions and red tape of health insurance (all increasing under ObamaCare) hamstring my office staff and interfere with my ability to take care of you.

What does provide an uninsured patient access to health care are laws that mandate that a hospital emergency room can’t turn you away when you are sick.

A false premise of ObamaCare is that mandating insurance for all somehow enables the ERs take care of all comers. In fact, studies show that Medicaid patients are much more likely to use the ER unnecessarily than are the uninsured. This clogs the ER and interferes with life-saving treatments for other patients.

Plus, the states, overburdened with administering the Medicaid expansion, will inevitably cut reimbursements to the hospitals, lowering the bottom line payments a hospital receives even as its volume increases.

Though politicians may even have the best of intentions when they compel you -- in defiance of the Constitution, in my opinion -- to purchase a product known as health insurance, in fact they are not even achieving their stated goal of providing for the public good, since this insurance doesn't equal care.

There wouldn’t even be a case before the Supreme Court if Congress and the president had stayed within their roles and expanded the National Health Services Corp and federal clinics expressly designed to care for the underserved. If there is a public health care need then let's get our government to provide for it directly.

In my office, and doctors’ offices across the country, the response to ObamaCare has changed.

Two years ago, when the law was passed, there was a pocket of patients who worked part time, had no health insurance, and looked forward to the day when they would be covered. But that early group of optimists has given way to a much larger group who worry that they will lose the employer-provided coverage they now have, and end up being forced to the state exchanges where they will be compelled to purchase (if the mandate survives) a policy they can’t afford with an inadequate federal subsidy.

Most of my patients are rooting for the Affordable Care Act to unravel especially if the individual mandate is declared unconstitutional. -- Transcripts and audiotape from the court this week make this possibility appear likely.

If ObamaCare somehow survives with or without the mandate, 16 million new Medicaid patients will quickly find out what current Medicaid patients already know; that it is very tough to find a doctor or network of doctors who will work with your insurance.

ObamaCare’s Independent Medicare Advisory Board and other regulatory committees and mandates will make it more and more difficult for doctors like me to practice and to order the tests and treatments we feel our patients need. We will require more staff hours to deal with all the red tape. As more of us drop out and no longer accept insurance, another unconstitutional mandate will become necessary to compel doctors to participate again.

Doctors everywhere are hoping and praying that dreaded day never comes. Even though the individual mandate and perhaps all of ObamaCare now appears to be in serious jeopardy thanks to the Supreme Court, doctors and their patients are not yet starting to breathe easier.

Marc Siegel, M.D. is a professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center.

Ah yes... the tyranny approaches.

Hell, who am I kidding?

The tyranny is already here!

Notice how our liberal friends have avoided this post like the plague?

I hope you don't gamble on those left-right games...in this country, it's a sucker's bet.

The American Medical Association voted to support the individual mandate by a 2:1 margin.

http://www.pbn.com/Doctors-group-maintains-support-of-US-health-law-mandate,59255

Your doctor has every right to express a minority opinion, but he ceded the high ground when he called it "ObamaCare" half a dozen time. It makes him sound like he has a personal ax to grind, instead of a professional position to express.

This just sounds like elitists are scared to wait in line with an influx of people (finally) being able to afford health care.

You really are clueless aren't you

The wealthy won't be waiting in any lines.

And those suckers who think Obamacare is a good thing are going to be in for the shock of their lives if it actually does survive.

They are going to learn what veterans stuck with the VA as their health care provider have known for years, government-run health care SUCKS!

They'll be dismayed to learn that scheduling an appointment with their assigned primary care physician takes at least a month, an appointment for any testing takes 1 1/2 to 2 months, and getting the results can take even longer. Government-directed and paid-for health care moves in ultra-slow motion, when it moves at all. Ask a Medicaid recipient. And the quality of care and the quality of doctors is only going to deteriorate for all Americans as their employers begin dumping their employees into the government exchanges because Obamacare mandates on what private insurers MUST offer makes their policies too expensive for employers to provide it.

Yeah, Obamacare is going to be a real dream - inasmuch as a nightmare is a type of dream.

Although I agree that insurance should not be mandated, cheaper insurance is better than NO INSURANCE.

In the 1940s GPs and consultants in Great Britain squealed like stuck pigs about the introduction of the National Health Service. I don't think anyone in the country - with the possible exception of some totally right-wing libertarian wingnuts - would agree with that point of view.

So, a doctor writes about Obamacare? Big yawn.

No.... no it isn't.

And what is missed by all the rhetoric and hyperbole by leftists wailing and gnashing of teeth about the poor, poor uninsured is that they needn't be uninsured if they genuinely are unable to afford insurance - THAT IS WHAT MEDICAID IS FOR!!! And we've had Medicaid since the 60's!

The simple truth is that leftist politicians just wanted to amass more power and control over our lives (and expand their government-dependent voter base in the process) - that is ALL Obamacare is about. It has absolutely NOTHING to do with providing better access to cheaper health care - that it does neither of those things makes it all too clear what the REAL agenda is.