Ahh…both my favorite and least favorite topic to talk about…healthcare reform. I feel that, being a physician practicing in a community hospital it is time to give my rant about this media-driven topic. There is way too much information that is left out (probably on purpose) about this bill that my readers…male and female..need to understand. It’s time to get dirty people..so let’s do it.
Although this “bill” has many many thoughts…the main point of the bill that most are focusing on is the increasing insurance coverage to Americans. Let me fill everyone in on this. The government is proposing that increasing medicaid will solve the problem. Newsflash…this will not even begin to help. Let me explain…medicaid is a government-funded insurance which is provided to low-income patients/ families. Sure, in theory this sounds great, but ask most people with this insurance how easy it is to find a doctor. Unfortunately, not at all easy. Why? Because the government’s reimbursement (or payment) to physicians for services rendered is deplorable. It is basically the equivalent of paying your plumber $5 to fix every pipe in your house. So, what happens is that the majority of physicians do not accept medicaid patients because frankly, they just do not get paid enough. You may see that a physician is a medicaid “provider” but this does not mean that he/she is actively accepting patients.
I urge everyone not to get upset reading this. It is just the simple truth. Most physicians have thousands (if not hundreds of thousands) of dollars in student loans…so you can imagine why a doc would not want to accept such an insurance who basically, does not pay them. I would bet that most docs would rather see an uninsured patient and have them pay a nominal fee cash, then deal with medicaid. So from this, you can see that increasing medicaid will NOT solve the “insurance” problem. All this will do is have more patients with an insurance that less physicians accept. Oh, and finding a primary care doc who takes medicaid is hard enough…good luck finding a specialist…few and far between!
The reform also implies that giving people access to insurance will reduce costs in terms of unnecessary ER visits. No way. Having insurance will not all of the sudden make people less scared. Patients will still continue to go to the ER at 2am with a cold or STD. Having insurance will not change that. There are “community health centers” in almost every town across America, which are completely underutilized because frankly, people would just rather go to the ER.
One of my biggest problems with the reform is the increase in tax on drug companies and medical device makers. Okay..let me fill you all in on some behind-the-scene stories. I can tell you all that not ONE day goes by where an insurance company (especially medicaid) denies a medication because it is too expensive. Although numerous studies show that the more expensive drug is WAY better then the cheaper one, they just don’t want to pay for it. So, what happens? The wonderful drug company typically offers the medication to those people who cannot afford it at a very discounted price or even FREE! Now, what do you think will happen when these companies begin to get taxed more? Goodbye free medication…and your doctor’s hands will be tied..This is the worst part of my job. Knowing that a patient could be getting a better medication or treatment, but their insurance company just will not pay for it.
Currently in this country, you are not denied medical care. If you walk into any ER needing an emergent surgery, having a heart attack, or any other real medical problem, you will get care, insurance or no insurance. No waiting, no payment upfront. So saying that “everyone deserves healthcare” is correct…and it is happening right now.
Sure, there are some good points..like an insurance carrier not being able to deny coverage based upon a pre-existing condition..thats great! However, overall, this bill is just a total mess…and until physicians who actually practice out in the real world everyday become a part of making this plan and reform better, we will not get anywhere.
There you have it…Obamacare’s Nuttiness in a Nutshell. I have another ten paragraphs I could write on this, and some solutions I have…but maybe they are better served in a different post..I know all of your eyes are getting awfully heavy!
Also, another doctor friend of mine had a lot to say about this topic..if you are still not convinced..:) You can check Dr. Manuel Diaz’s thoughts…here
Dr. Tiffany Sizemore-Ruiz