The Association of American Medical Colleges in a recent study has projected that there will be a doctor shortage between 42,000 and 120,300 by 2030. This is a stunning number when you break down the fact that the shortage will affect primary care doctors (14,800 - 49,300); specialists (33,800 - 72,700); and surgical sub specialists
The King vs. Burwell decision has answered the question of who stands to gain in the age of Obamacare. Justice Roberts in his opinion said it best “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.” With this decision medical insurance companies, hospitals and other pieces of the corporate healthcare delivery system now have the scale clearly tipped in their favor at the expense of doctors the patients – the mission has been accomplished.
The disastrous roll-out has certainly fed the argument of single payer and there is an argument to be made that the government bailout written into the bill has actually already ushered in single payer - since whoever controls the money controls the access and makes the rules.
When the system is overwhelmed and breaks, as it was intended, the end result will be a complete takeover of the healthcare system by the government as single payer, socialized medicine. There will also be another enormous change in our country. There will be a transfer of wealth, not from the rich to the poor, but instead from the middle class making them dependent on the government.
Most Americans probably never realized that the much touted transfer of wealth was not going to be to those in the middle class, but instead would be taken from the middle class in taxes raised by Obamacare in order to enrich cronies like AARP, Big Pharma, hospitals and the medical insurance industry who advocated for passing the bill. Now that it has passed and we know what is in it, physicians must decide if they will honor their Hippocratic Oath and stop participating in a system which forces them through fear and coercion to act against the interests of their patients before they have no choice.
Mayor Bloomberg’s ban on large soft drinks, trans fats , salt, and now the assault on a new mother’s right to choose how to feed her baby is a stark reminder that whoever pays has the power to control.
By passing the Affordable Care Act, the Supreme Court has effectively ended patient centered medicine.
The Democrats and the Republicans have done a masterful job of demonizing the physician. The doctor has been the scapegoat for skyrocketing health care costs while giving more power over the medical industry to those entities that have been the architects of the broken healthcare system that we have today. In short, the system is a complex network of corporate middlemen, that have worked tirelessly figuring out ways to skim profits while simultaneously shifting the costs to patients, rationing their care in the form of pre-certifications, increasing premiums, and outright denials on one hand while decreasing physician reimbursements (in the form of bundling), lowering fees, implementing recovery audits to claw back reimbursements, and outright denials of payment after services are rendered on the other. The government has put rules and regulations into place that encourage and reward this behavior, while ensuring that doctors and patients continue to feed a beast that needs increasingly more money to run a system that is based on the management of chronic disease instead of true prevention. It is no wonder that we are spending more money on healthcare and are on more medication, yet we as society are getting sicker.
Obamacare has become one of the most polarizing pieces of legislation ever passed. There was so much heat surrounding its passage that people got caught up and blinded by the rhetoric. On one hand, we were told that it had to be passed because uninsured people were practically dying in the streets, while greedy doctors were performing unnecessary tests, amputating feet, and taking out tonsils in their unending quest to make as much money as possible. The initial premise that the problem with healthcare was because of the uninsured was a lie.
For those who continue to delude themselves that Obamacare will lead them to the healthcare land of milk and honey, I have some news for you -- it’s never going to happen. Critical thinking would lead one to the conclusion that there is no way to add 30 million more people to a system that is already fundamentally broken. There have been many arguments used to sell Obamcare to the public. Much of it has been disingenuous, peddled not by doctors who are on the front line taking care of patients to the best of their ability, but by corporate interests that stand to gain from profits gleaned from the practice of corporate disease driven medicine. e.g., the pharmaceutical industry, the American Medical Association, AARP, The Hospital Corporation of America, and various unions.