NCPA - National Center for Policy Analysis

How Obamacare Is Ruining Access to Doctors

November 20, 2014

Dependence on government health care, both Medicare and Medicaid, is only growing. Over the last 10 years, the number of Americans over the age of 65 has risen by 6 million. Of the 8.5 million who enrolled in the exchanges during 2014, over 6 million enrolled in Medicaid. Scott Atlas, senior fellow at the Hoover Institution, says that 140 million Americans will have government health insurance by 2020.

What does the rise in the number of Americans on Medicare and Medicaid mean for health care? Reduced access to care. Already, a majority of American doctors refuse to treat Medicaid patients, and more than 20 percent of primary care doctors refuse to accept new Medicare patients -- five times larger than those who refuse to accept new patients with private insurance. And the number of those refusing to accept Medicare is growing: 10,000 doctors chose not to participate in Medicare in 2012, three times larger than those who opted out in 2009.

America is also facing a doctor shortage of 124,000 physicians by 2025, two-thirds of which will be in specialist care. This is significant, because seniors (who are on Medicare) rely heavily on specialists. Unfortunately, writes Atlas, fewer doctors are going to want to enter the profession due to cuts, noting that the Medicare Payment Advisory Commission has recommended cuts to specialists that, after adjusting for inflation, will amount to a 50 percent drop in payments after a decade.

Not only will there be fewer doctors to choose from, but insurance plans are limiting access to those doctors who are available in order to keep premium costs down, offering insurance plans that offer relatively few health care providers. According to a report from McKinsey, the vast majority (68 percent) of Obamacare insurance plans provide enrollees with access to narrow or "very narrow" networks, and most of America's best cancer care hospitals are not included in state exchange plans.

As Atlas explains, government policy is reducing the attractiveness of becoming a doctor and limiting patients' ability to access specialists and seek care at the nation's best hospitals.

Source:  Scott Atlas, "If you like choice in health care, look to Republicans,", November 18, 2014. 


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