After posting a recent blog article, a person very familiar with the medical field commented with her grave concern about the full implementation of Obamacare. I want to share with you thoughts from the wife of a doctor. I chose to change the names to protect her and her husband from backlash.
Some doctors plan to open private practices and run them on a cash only basis. Your husband is one of those making that decision. Can you explain why that is?
“James” wants to do cash only because Medicaid has already been cut back to the point that doctors lose money treating medicaid patients. I think ”James” said the other day it was cut by 10% already recently.
Does he see a high volume of Medicaid patients and does he also encounter many abusing the system?
He sees a high percentage of Medicaid patients in the ER for runny noses, sore throats, etc., because the ER is mandated never to turn away anyone. The only states allowed to turn away non-emergent patients are Oregon and I think Maryland. That was pre-Obama, but “James” sees it getting much worse. Doctors and other personnel are already scattering from the hospital where ”James” works because they see what could be coming. There are places in area cities called Access Care where Medicaid patients can get appointments, but they don’t want to wait. The abusers of the system are the drug abusers who are also often Medicaid patients whose only problem is they can’t hold a job because they abuse drugs. The Medicaid system is a mess, and when ”James” reports Medicaid abuse, the answer he gets is, “So what?” Medicaid abuse is when a woman attempts to bring seven children into the ER–most of whom aren’t hers–to get their runny noses checked, their ears checked, etc., pushing back those who are truly emergency patients. It’s also when a drug abuser lies to the doc to get narcotics.
What’s another problem you envision with the Affordable Health Care Act?
If Obamacare goes through, it appears that everyone without insurance will either be forced to pay what they already can’t pay, or we will be forced to place them on some kind of Medicaid type insurance. “James” doesn’t want to be in the ER when that happens. God help us if Obama is president for another four years, because there are so many people who cannot afford insurance. Of course, much of that comes from greed, not from Obama. Hospital administrators, drug companies, many specialists and doctors in high demand already make their riches off patients. On the other hand, “James” present employer, is cutting way, way back on personnel, pay incentives, and vacation pay (cutting that out.)
Have I heard correctly that Doctors are being/or will be forced to work longer hours?
Yes, they are forcing doctors to work more hours because they lost tons of money last year. Government payments have been cut back.
What are some other issues “James” faces in the medical field?
Well, there is plain old human stupidity. There was the time a few months ago when a police officer brought a prisoner in to get checked out before they could jail him because he had some trumped-up medical problem. He’d called a friend to meet him down the street from the ER. The doc (not “James”) and a male nurse just happened to see the prisoner slam the door shut as he was going for the police officer’s weapon–the police officer had no restraints on the prisoner. The doc and the nurse had to rescue the police officer from the prisoner. Had they not wrestled the prisoner down, he was apparently going to shoot his way out of the ER. The ER is the underbelly of society, and yes, we do help the poor, but the welfare system is filled with able bodied people who could get a job but won’t. That takes away from those who truly need it. This, however, has been going on long before Obama came into office….
What are your thoughts on the Medicare system?
Medicare is apparently probably also in trouble, but not so much, though I haven’t read the 1000 plus page Obamacare report. “James” will likely be able to have about a 20% Medicare patient load, which he will like, because he loves working with the elderly who have worked their whole lives and don’t have the issues of a third generation welfare recipient. That could all change with Obamacare, but Mom had a secondary insurance that worked quite well with Medicare.
At our recent emergency room visit, an RN worried that lengthy lines awaited all when Obamacare officially starts. Do you agree?
“James” isn’t so sure about the lines to private care practitioners. He knows the ERs will burst out of their walls with patients who will break the systems, the hospitals, etc. But most people who will be forced to get insurance will get catastrophic insurance, and will pay cash for trips to the doctor. No one will soon be able to afford anything but catastrophic insurance because of the backlash from insurance companies against the hospitals.
And you think this rush to utilize the emergency rooms threatens the livelihood of hospitals?
I believe that when hosptials go out of business because of the ER boom (and this is just my concern), that they could be taken over by the government. Do they have the ability to manage anything capably? “James” doesn’t want to be a part of that. Government regulations have long been the boon of ERs. They were that way 18 years ago when “James” was ER director in a small town in Southern Missouri. Federal regulations become more restrictive every year, and now Obamacare?
Does your husband have any more concerns?
“James” does have a lot more concerns. He wants to be able to treat patients like people, not cattle being run off a ramp. He wants to take time with them and get to the bottom of their problems instead of simply easing their pain and sending them on to another hospital. He’s saved a lot of lives in the ERs over the years, and he’s made a lot of friends. He has had many patients ask him if he would be their family doctor. Patients are happy when he walks through the door, because he treats everyone with respect and kindness, even those children with runny noses who are bouncing off the walls and healthy. He does NOT want to work in a larger hospital, because it’s even worse there. We know a lot of docs in this area who have filled up their practices quickly doing cash-only, giving the patients a superbill so they can turn it into insurance if they have it. No extra paperwork for us except Medicare, no battling multiple insurance companies over and over and over again because some idiot knows nothing about medicine and refuses to pay for necessary tests. I want us to make more money than he’s making now because he’ll be paying at least one nurse and one office worker, and I’d love for us to be able to pay for their insurance. But Obamacare is a farce. We want nothing to do with it.
Any last thoughts? (And these answers came directly from James…in an email)
I would mention one more thing. Basically I fear with Obamacare everyone will be getting on the Medicaid bandwagon, since I basically see Obamacare as a gigantic increase in Medicaid. Since family physicians always lose money on Medicaid and since the Medicaid numbers will explode, family physicians will be forced to take early retirement or stop taking any government assignment. Obamacare people would be offended they would be expected to actually help pay for their care so they will head for the E.Rs where they can’t be turned down. Also, Obamacare boasts it will cover at least another 40 to 50 million people and not one penny actually will go to hiring so much as one more ER tech. Talk about a recipe for disaster.
Thanks so much to “James” and his wife “Katherine” for taking the time to answer some of the questions troubling many American’s minds. It looks as if Obamacare poses a threat to our Country’s freedoms and to the quality of care issued by healthcare providers. We need to do everything possible to reverse course.