Doctor Shortage

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This is especially so if you are a new patient, do not have health insurance, have Medicare, Medicaid or PeachCare. So if we are having problems now, what happens when it is free?

Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the number of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president.

You can’t just push a button and “poof” you have new doctors. It takes years to “grow” a new crop of docs.

One proposal — to increase Medicare payments to general practitioners, at the expense of high-paid specialists — has touched off a lobbying fight.

This is called squeezing the balloon.

Cut reimbursement to one sector to cover the cost of services for another sector. It is also known as robbing Peter to pay Paul.

That has never worked. Why would Obama-man think it will work now?

And the doctor shortage is not just limited to those without insurance or on taxpayer plans such as Medicare, Medicaid and PeachCare.

Miriam Harmatz, a lawyer in Miami, said: “My longtime primary-care doctor left the practice of medicine five years ago because she could not make ends meet. The same thing happened a year later. Since then, many of the doctors I tried to see would not take my insurance because the payments were so low.”

Sounds almost like a doctor strike.

Sen. Max Baucus, Democrat of Montana, chairman of the Finance Committee, said Medicare payments were skewed against primary-care doctors — the very ones needed for the care of older people with chronic conditions like congestive heart failure, diabetes and Alzheimer’s disease.

“Primary-care physicians are grossly underpaid compared with many specialists,” said Baucus, who vowed to increase primary-care payments as part of legislation to overhaul the health-care system.

The Medicare Payment Advisory Commission, an independent federal panel, has recommended an increase of up to 10 percent in the payment for many primary-care services, including office visits. To offset the cost, it said, Congress should reduce payments for other services — an idea that riles many specialists.

I don’t think this spreading the wealth thing is catching on.

Dr. Peter J. Mandell, a spokesman for the American Association of Orthopaedic Surgeons, said: “We have no problem with financial incentives for primary care. We do have a problem with doing it in a budget-neutral way. If there’s less money for hip and knee replacements, fewer of them will be done for people who need them.”

Sounds like rationed health care. This can’t be good.

The experience of Massachusetts is instructive. Under a far-reaching 2006 law, the state succeeded in reducing the number of uninsured. But many who gained coverage have been struggling to find primary-care doctors, and the average waiting time for routine office visits has increased.

These grand ideas of health care for all doesn’t seem well thought out. But then, it is Washington . . .

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