One City Built to Last

Arragg also sees the nation’s already
crowded emergency rooms being
forced to take up the slack, as patients
unable to get care from a primary physician
resort to a place where they cannot
be turned away.
Devon M. Herrick, a senior fellow at
the National Center for Policy Analysis
in Dallas also forecasts that trend, especially
for Medicare patients. According
to the Obama Administration, more
than six million new enrollees opted
for Medicare and the Children’s Health
Insurance Program – neither of which
are tied into the ACA health care exchanges
– during the same time period
that Obamacare had its first enrollment
phase. The trouble is, the government
isn’t quite sure yet about that six million
number. The Center for Disease
Control and the Census Bureau both
released varying numbers in August.
While the numbers differ, the effect
remains the same. Because Obamacare
lowers the dollar amount physicians
are reimbursed for Medicare patients,
it is quite likely that Medicare patients
who do have a primary care physician
may have trouble getting an appointment,
especially if the practice limits
the number of patients that can be seen
within the economic demographic. Or,
worse yet, doctors within the community
will simply stop accepting Medicare.
“With limited resources, more
Medicare patients will turn to the
emergency room,” Herrick said.
He sees yet another access issue
looming. Doctors, noting the laws of
supply and demand, may opt to not
only limit the type of insurance they
accept, but may also begin charging
patients a retainer fee to remain in their
practice.
“There aren’t enough doctors to treat
all the new enrollees,” he said. “The
ones most likely to suffer are those
whose insurers pay the lowest reimbursements.”
The government itself admits a possible
supply and demand problem exists.
Its own statistics from the Health Resources
and Services Administration
– the federal agency whose mission is
to improve access to health care – indicate
that 20 percent of Americans
currently live in geographic areas with
an insufficient number of primary care
doctors. This is determined via federal
guidelines dictating that each primary
care doctor should have no more than
3,500 patients. Federal guidelines for
dental and mental health professionals
are even larger: a 5,000 patient limit for
dentists and no more than 30,000 patients
for mental health providers.
According to the same agency, in addition
to those who living in areas with
an insufficient number of primary care
doctors, sixteen percent live in areas
with too few dentists and a whopping
30 percent are in areas that are short of
mental health providers.
How this plays out, remains to be
seen.
THE SUIT MAGAZINE p.17