More About Medicare and Obamacare

Full implementation still awaits the beginning of 2014, but researchers are finding clear trends in medical delivery and pricing as we prepare for Obamacare. The reports are springing up now, because we hit the third anniversary of enactment of the Affordable Care Act of 2010.

A key trend identified is a medical provider shortage, especially a doctor shortage. Fewer people are going into medicine, and many of those in medicine are retiring, often earlier than initially anticipated. Another trend is rising costs. These trends already began before the law has taken effect or the government even has issued all its regulations.

The burden appears to be falling especially on Medicare beneficiaries. Reimbursements to insurers for Medicare Advantage plans are down, resulting in higher premiums, deductibles, and copayments or reduced coverage or both. Medicare beneficiaries also are going to suffer from less service and coverage. There’s a summary of the recent research here.

It’s not hard to figure out why there’s so much discontent. Four in ten doctors reported to Deloitte that, from 2011 to 2012, their income fell. A full 40 percent of those whose income was cut blamed Obamacare. Nearly half of all doctors (51 percent) believe physicians’ incomes will fall dramatically in the next one to three years. In addition, doctors see little chance for positive reforms passing Congress. Only one in ten expect meaningful medical-liability reform to become law in the next one to three years. Only a quarter think Congress will change its practice of ratcheting down Medicare reimbursements.

The crackdown on Medicare reimbursements has meant that seniors have less access to doctors. A fifth of doctors overall and 31 percent of primary-care physicians are now limiting the number of new Medicare patients they accept. Those numbers are expected to grow as spending is squeezed on privately managed Medicare Advantage plans and other programs in order to pay for Obamacare’s expansion of health-care benefits to the uninsured. “Medicare patients are likely to have a tougher time seeing their doctors,” says Grace-Marie Turner, president of the Galen Institute, a health-care think tank. “Every day about 10,000 Americans turn 65. It’s estimated 25 million new Medicare recipients will be joining the program by the year 2020.”