Will doctors continue to accept Medicare?
With the nation trillions of dollars in debt and in the midst of a financial meltdown, President Obama and Democratic majorities in the U.S. Senate and House of Representatives grandly imposed upon the public the Affordable Care Act.
A crisis, an administration official explain, is a terrible thing to waste.
This vast new medical entitlement program amounts to a government takeover of a sixth of the U.S. economy.
Politically, its function was to obscure the looming crisis in the vast medical programs the federal government already runs. Now, with 78 million American baby boomers heading for Medicare, those problems are evident.
The Statesman Journal in Oregon reported recently that seniors in rural areas are having increasing trouble finding primary care physicians who will take Medicare.
"First, many primary care doctors prefer to live and work in rural areas because of greater cultural activities, better schools, and job opportunities for spouses," the paper said.
"Also, Medicare pays rural doctors less per procedure than urban physicians because their operating costs are supposedly less. This makes rural doctors less likely to accept Medicare patients."
How much less?
Dr. Bruce Stowell of the Grants Pass Clinic said it is no longer taking new Medicare patients because Medicare pays about 45 percent of what commercial insurance pays.
The clinic is having big trouble recruiting physicians.
And the refusal of Medicare patients because of low reimbursement is spreading in Oregon.
A 2009 survey of doctors in the Oregon Medical
Association showed that 19.1 percent of Oregon physicians had closed their practices to Medicare, and 28.1 percent had restricted the number of Medicare patients they would accept.
The Affordable Care Act includes cuts to Medicare reimbursement of doctors.
If those cuts occur, "the doctors are saying, 'We're out of here,' " said Mark Pauly, professor of health care management at the University of Pennsylvania.
"'We'll treat Medicare patients like we treat Medicaid patients,' which is mostly not."
Politicians can mandate many things and entitle
people to all sorts of services - and have.
It doesn't seem to have crossed Democrats' minds that doctors can't operate at a loss, making the whole grand vision a mirage.