Tuesday, November 16, 2010

Obamacare - The Day After




We were told Obamacare was going to help the “less fortunate” amongst us have access to healthcare.  We were also told that those of us who wanted to keep our doctor … could.  (Never mind that Obamacare ignores addressing the ever-increasing demand of medical services on a dwindling supply of medical practitioners.)  Not so according to the letter that I received from my doctor today.  

Apparently, my primary care doctor is switching to a membership based practice.  Why? In his word, "[u]nder the current healthcare system, it's becoming increasingly difficult for doctors to provide the kind of personal attention and individualized care that's the hallmark of a top medical practice.  Many doctors are instead forced to run their practice like an assembly line, squeezing in as many patients visits into a day as possible."

Not stated here is that along with an increase in government mandates and patient demand come price caps on what doctors can charge.  Therefore, the cost of renderings service is often much greater than what a doctor can ultimately charge. 

So, how is my doctor responding to the rising costs? Get this … for the "small membership fee" of $60 per month (40% of my monthly insurance premium) I will have doctor priority for appointments, email/voicemail contact with the doctor, and personalized care coordination.  All of which I would expect from my doctor with the fee my insurance pays.  Anyways, here’s what the letter states:
Top physicians implement membership practices in order to provide more personalized care to their patients including having more time to focus on prevention and wellness.  The select few patients invited to join Privia are uniquely committed to their patients and are known for going 'above and beyond' in making sure their patients get the best available care.  The modest monthly membership fee enables these top physicians to have access to the latest technologies, and give them the time needed to provide patients the highest levels of individual attention.

So what if I don't join this club?  Sure … I can always continue to use my current insurance plan.  But as the letter states:
Your doctor is committed to the membership practice model and is asking all current patients to join.   Unlike with concierge medicine, if you do not join you may still see your doctor in the office.  Over time, as the membership practice fills up, you doctor may ask non-member patients to see another provider in the office for routine visits - which may include a physician assistant or nurse practitioner.

So my initial takeaways are:
  • We see an influx of patients, more than we are built to handle
  • We will give you more access and care if you pay outside of our normal fees
  • Despite claims that Obamacare would get more people access to healthcare (link above), doctors are getting around it and making it more difficult for the poor to get access to healthcare (membership club)
  • The poor who are insured will have their access to healthcare reduced since they are less likely to pay for these fees
  • The HMO model is spreading
This is yet another example of the failure of government mandates.  Once again, elections have consequences.  Unless something is done quickly … one of the consequences from ’08 might be trickle up poverty.

- GUEST POST (The Turbanator)