California Weighs Redefining Who Qualifies as a 'Doctor' to Cope with Obamacare's Shortages

Posted: Feb 12, 2013 12:58 PM

Kudos to Michelle Malkin for her enlightening post on the ongoing mess that is Obamacare, which begins by quoting a panel of liberals scoffing at her warnings about America's doctor shortage crisis.  But beyond the insular precincts of liberal conventional wisdom, the nation's healthcare law is no laughing matter -- as the patients of California will discover soon enough:

As the state moves to expand healthcare coverage to millions of Californians under President Obama's healthcare law, it faces a major obstacle: There aren't enough doctors to treat a crush of newly insured patients. Some lawmakers want to fill the gap by redefining who can provide healthcare. They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure...Doctors say giving non-physicians more authority and autonomy could jeopardize patient safety. It could also drive up costs, because those workers, who have less medical education and training, tend to order more tests and prescribe more antibiotics, they said.  

This is classic leftism: Create or exacerbate a problem by intrusive and expensive government action, then "fix" the mess with additional government decrees.  In this case, the big government solution involves defining "doctors" down -- and it may actually increase costs, to say nothing of putting patients at risk.  So Californians who show up to see the doctor may have no choice but to see someone without a medical degree.  But at least they're covered, right?  Thanks, Obamacare!  The Golden State, currently drowning in debt, is already grappling with an acute doctor shortage:

Currently, just 16 of California's 58 counties have the federal government's recommended supply of primary care physicians, with the Inland Empire and the San Joaquin Valley facing the worst shortages. In addition, nearly 30% of the state's doctors are nearing retirement age, the highest percentage in the nation, according to the Assn. of American Medical Colleges.  

Surveys have shown that physicians nationwide are retiring early and shuttering their practices in advance of Obamacare's full implementation, and the percentage of doctors who have their own practice is cratering.  The Washington Times profiles some of the doctors who are bidding a premature adieu to their chosen profession:

After 25 years of practicing medicine, Dr. Tamzin Rosenwasser packed in her dermatology practice in 2011, barely a year after the passage of President Obama’s health care initiative. The timing wasn’t coincidental. “I have interrupted practicing medicine because of Obamacare,” said Dr. Rosenwasser. “I’d read the bill. I was conversant with what had already happened with Medicaid, and I didn’t want to go down that road with Obamacare.” The Affordable Care Act isn’t scheduled to be fully implemented until next year, but some doctors already are viewing it as dead on arrival. The medical rumor mill is abuzz with stories about physicians girding for Mr. Obama’s signature domestic policy achievement by limiting their exposure to Medicare and Medicaid, selling their practices, converting to fee-for-service approaches, or even retiring from medicine altogether. “Every single day, people are talking about retiring early, getting out of clinical medicine, or going into hospital administration, where you don’t have to think about patient care anymore,” said Dr. Richard Armstrong, a Michigan surgeon...

Keep in mind that these deleterious consequences are materializing before the unpopular law goes into full effect.  One can only imagine how America's healthcare landscape will look when Obamacare's exchanges are exposed as underprepared (or non-operational) to handle the glut of new patients.  Millions are expected to lose their current insurance, and the government may be logistically ill-equipped to help them obtain approved and/or subsidized healthcare plans.  Other loopholes in the law are poised to make many family rates totally unaffordable while slamming the door on eligibility for subsidies.  Among those who will endure the most bruising hits are younger Americans, who stand to pay much more for coverage than current plans -- or basic market principles -- dictate:

State and federal officials and the health care industry are currently preparing to implement two specific ObamaCare provisions taking effect on January 1, 2014, acting on this politically perverse principle of shifting resources from your supporters to your opponents. The first is the individual mandate, which aims to force the young, childless, and healthy — "Young Invincibles," as they are said to think of themselves — to buy health insurance, even if they think (and even perhaps make a rational, if risky, bet) that they don't need it. The second is a lesser-known policy to limit the practices of charging different premiums to different ages, known as age-rating. Many states currently set a limit on this difference, often mandating that an old person shouldn't pay a premium more than five times a younger person's, even if she's expected to use more than five times as much health care. The ObamaCare provision kicking in next January 1 would reduce that ratio to three-to-one, essentially limiting what the elderly pay in part by forcing young people to carry a larger share of the total cost of national health care.  

I'll leave you with a link to this Wall Street Journal column, which argues (as we have, for years) that Obamacare is failing to achieve virtually every single promise on which it was sold.  One case in point: The CBO's latest budget report projects national healthcare costs will skyrocket over the next ten years -- dramatically outpacing revenue growth, economic growth, and other forms of spending.  So much for "cost curves down," and all that. 

UPDATE - Ashley Brooks explored California's doctor foibles yesterday.