by Marc Siegel
At the heart of the multi-headed abominable creature known as Affordable Care Act aka ObamaCare, there resides a singular deceit. It is too easy for lawyers and even U.S. Supreme Court Justices to miss this deceit in the process of arguing abstractions, but I and other doctors experience this reality every day our offices
Insurance does not equal care. One patient’s needs can get in the way of another’s needs. My waiting room is like so many others in America, and when it is clogged with several patients with low-paying highly-regulated insurance, the waiting times goes up and the access to quality medical care goes down.
That is it in a nutshell. The rest follows something like this.
It is not true that health insurance automatically provides you with that care.
I can tell you as a practicing physician that the regulations and restrictions and red tape of health insurance (all increasing under ObamaCare) hamstring my office staff and interfere with my ability to take care of you.
Though politicians may even have the best of intentions when they compel you -- in defiance of the Constitution, in my opinion -- to purchase a product known as health insurance, in fact they are not even achieving their stated goal of providing for the public good, since this insurance doesn't equal care
There wouldn’t even be a case before the Supreme Court if Congress and the president had stayed within their roles and expanded the National Health Services Corp and federal clinics expressly designed to care for the underserved. If there is a public health care need then let's get our government to provide for it directly.
This service could easily be expanded to provide coverage in rural areas, underserved communities and function as a ‘payback’ for increasingly expensive loans to students. It would also serve as a public service for young physicians. Initially when first formed it served as period between internship and specialty residency. In today’s world it could also serve as a primary care or family practice residency. The change from a free standing internship to an integrated PGY residency has had the effect we now see in inadequate primary care physicians. When I graduated from medical school in 1968 this was known as the US Public Health Service.
Most of my patients are rooting for the Affordable Care Act to unravel especially if the individual mandate is declared unconstitutional. -- Transcripts and audiotape from the court this week make this possibility appear likely.
If ObamaCare somehow survives with or without the mandate, 16 million new Medicaid patients will quickly find out what current Medicaid patients already know; that it is very tough to find a doctor or network of doctors who will work with your insurance.
ObamaCare’s Independent Medicare Advisory Board and other regulatory committees and mandates will make it more and more difficult for doctors like me to practice and to order the tests and treatments we feel our patients need. We will require more staff hours to deal with all the red tape. As more of us drop out and no longer accept insurance, another unconstitutional mandate will become necessary to compel doctors to participate again.
Marc Siegel, M.D. is a professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center. He is a member of the Fox News Medical A team and author of several books. His latest book is "The Inner Pulse; Unlocking the Secret Code of Sickness and Health."
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