Obamacare- The Next Hurdle? The Shortage of Doctors

It’s interesting. The country has been debating the pros and cons of the Affordable Care Act since it began in 2010. Unfortunately, until the discussion became relevant to the broader population the general public had remained largely detached.  Yes, some good things have come out of the law to help some of those with pre-existing conditions and to help the system finally start to work on prevention. But many questions about how all the pieces are going to fit together remain.

The debate about health care has been primarily political instead of looking out for what is good for the country and its citizens. Neither side has been willing to try to fix the cumbersome, complex, and expensive law that was enacted. It’s been all or nothing for both and we’re now living with the consequences.

I’ve been following the ACA since the beginning and I’m not all that surprised with the failure of the www.Healthcare.gov web site to work. The processes we are using to manage our government systems are dysfunctional- and the website rollout is a product of that dysfunction.

The country is now focused on www.Healthcare.gov because of the poor implementation and execution of a fundamental feature of the legislation. This rollout was very visible to most, and health care suddenly became more relevant to many.

But, www.Healthcare.gov is only the beginning. Once the site is fixed and running, more individuals will be participating in the broader health care system than before. The website is simply the pipeline for access into the delivery system.

What then?

The most likely answer lies in Massachusetts. After a similarly difficult rollout in the beginning, over 96% of all Massachusetts residents now have health insurance.  But they are facing other problems.

The Massachusetts Medical Society released two reports (2013MMS Patient Access to Care Study; and 2013 Workforce Study) that are likely indicative of what will happen nationally once more individuals enter the health care market.

In 2013, wait times in Massachusetts to schedule appointments with providers ranged from 22 days to 50 days for more routine services. Only 45% of internal medicine practitioners and 51% of family medicine practitioners are now accepting new patients. And a quote from one study states, “With no intervention, health care spending in Massachusetts will double by 2020.”

Even before the ACA was implemented, the country was projected to experience a significant shortage of primary care physicians by 2020. With more people entering the system, that shortage may occur much sooner. Obamacare will certainly be blamed- some of it justified for not addressing the problem before adding to it, some of it not because the problem existed anyway.

Consumers need to be prepared to wait longer and may have to spend more time finding a physician. In some cases (and regardless of the sales pitch) you may not be able to keep your doctor due to the realities of the market. It’s a simple matter of supply and demand.

Be prepared. And don’t be surprised or shocked when it happens. The politics of Obamacare is one thing, the reality is another.