Forbes article "ways to protect yourself against Obamacare"

[bu villain]

The medical field is already short primary care docs. There is simply no interest in the relatively low pay and large workload.

That is a problem but the answer isn't to price poorer people out of the healthcare system which is what is happening now.

[BanginJimmy]

It's not a problem because they will not be "subjected" to it. It will simply be an option for everyone and the people who can afford exceptional healthcare will still be able to get the top of the line stuff. The fact we have high quality care now doesn't matter to those who can't afford it. I understand the system right now probably works fairly well for you and me but that doesn't mean it does for everyone. When it comes to healthcare, we need a system that works for everyone.

We will all be subjected to it simply because we are in the US and forced to buy insurance. Obviously we are talking on a hypothetical scale right now, but it is already happening with reduced access for medicare/medicaid, it will get worse and be more far reaching when 12mil more people are added to the system.

Here is an article from 2009 that lays out the situation pretty well. Its only real deficiency, it was written before Obamacare passed so its numbers about doc shortages are too low.
Finding a Doctor Who Accepts Medicare Isn’t Easy - NYTimes.com


Here is a pretty good article about doc shortages. Notice the chart to the left that breaks down the shortage with and without Obamacare.
http://www.nytimes.com/2012/07/29/he...mmunities.html

The lower quality care will start with assembly line style consultations and low waits. When, not if, costs start getting out of control, it will further lower the quality as docs are forced to use cheaper, less aggressive or less efficient methods of diagnosing and treating their patients.

That is a problem but the answer isn't to price poorer people out of the healthcare system which is what is happening now.

Your average poor person can afford a major medical plan. They just have do decide which luxury item to do away with. Maybe its cigs, maybe its a smart phone, maybe its a new car every 4 years.

I just did a quick search and its possible to get a decent major medical plan for under $100 a month. BCBS offers one with a 2k deductable and an RX plan for about $75.

There is a very long list of reasons health care is getting more expensive. One of the biggest is under payment for medicare/medicaid. Another is the use of emergency rooms for non emergency care. Neither of which will be improved under Obamacare. One of the articles I linked thinks it will actually get worse.

[bu villain]

We will all be subjected to it simply because we are in the US and forced to buy insurance. Obviously we are talking on a hypothetical scale right now, but it is already happening with reduced access for medicare/medicaid, it will get worse and be more far reaching when 12mil more people are added to the system.

The lower quality care will start with assembly line style consultations and low waits. When, not if, costs start getting out of control, it will further lower the quality as docs are forced to use cheaper, less aggressive or less efficient methods of diagnosing and treating their patients.

The reason we don't have to wait long now is because there are millions of people who aren't going to the doctor even though they should be. That is worse in my opinion than everyone having to wait for checkups, non lifethreating procedures, etc. The solution is to bring down costs and make it easier to train doctors, not to reduce access to healthcare.

Your average poor person can afford a major medical plan. They just have do decide which luxury item to do away with. Maybe its cigs, maybe its a smart phone, maybe its a new car every 4 years.

I just did a quick search and its possible to get a decent major medical plan for under $100 a month. BCBS offers one with a 2k deductable and an RX plan for about $75.

Yes a major medical plan is affordable for many people but not so much for others. First of all you are quoting a pretty optimal scenario (relatively healthy, young, individual as opposed to older, less healthy, family). The fact is that advertised plans on ehealthsurance.com or similar sites are often not the real cost once the application process is complete and they account for even the most minor health issues. Once you get coverage, that's just the start of your medical payments, not the end. Further, it is only as cheap as it is because people with significant health issues are disqualified from the get go.

There is a very long list of reasons health care is getting more expensive. One of the biggest is under payment for medicare/medicaid. Another is the use of emergency rooms for non emergency care. Neither of which will be improved under Obamacare. One of the articles I linked thinks it will actually get worse.

I agree that Obamacare doesn't do anything for cost. The big win from Obamacare is that preexisting conditions can't be denied. The mandate is an unfortunate necessity (otherwise everyone would sign up for insurance only after getting sick). For that reason alone I am happy Obamacare was passed. Now we need to focus on bringing costs down.

[BanginJimmy]

The reason we don't have to wait long now is because there are millions of people who aren't going to the doctor even though they should be. That is worse in my opinion than everyone having to wait for checkups, non lifethreating procedures, etc. The solution is to bring down costs and make it easier to train doctors, not to reduce access to healthcare.

I agree, the waits arent as long now because of cost. After Obamacare is fully implemented, there will be long lines for care and fewer docs to provide that care. About 1/3 of all primary care docs are over 55 and able to retire.
Will There Be Enough Doctors?

Making it easier to train and certify docs means lesser qualified docs. Another reason Obamacare will result in lower quality care for the masses. And you point out later, there is absolutely nothing that will bring down costs, only make healthcare more expensive for those that actually do pay for it ourselves, no matter what form those payments take.

Yes a major medical plan is affordable for many people but not so much for others. First of all you are quoting a pretty optimal scenario (relatively healthy, young, individual as opposed to older, less healthy, family). The fact is that advertised plans on ehealthsurance.com or similar sites are often not the real cost once the application process is complete and they account for even the most minor health issues. Once you get coverage, that's just the start of your medical payments, not the end. Further, it is only as cheap as it is because people with significant health issues are disqualified from the get go.

I have stated several times preexisting conditions is where the govt needs to step in. I would prefer that people requiring long term care for a preexisting condition be allowed to enroll in a new form of medicare that has income based premiums.

I agree that Obamacare doesn't do anything for cost. The big win from Obamacare is that preexisting conditions can't be denied. The mandate is an unfortunate necessity (otherwise everyone would sign up for insurance only after getting sick). For that reason alone I am happy Obamacare was passed. Now we need to focus on bringing costs down.

The preexisting conditions mandate isnt a win. It is a loser for everyone. Now, everyone's premiums will be forced higher to pay for the sick. How many thousands of healthy patients do you think it would take to cover a single cancer patient when the insurance company not only HAS to enroll them, but cannot charge them in accordance with their current health? Instead of charging the sick guy 500 a month and charging me 50 a month, both of us will be charged 275 a month. Oh, and if cancer patient goes to the federal exchange for subsidies, the govt gets a say in how much care he gets.

[bu villain]

I have stated several times preexisting conditions is where the govt needs to step in. I would prefer that people requiring long term care for a preexisting condition be allowed to enroll in a new form of medicare that has income based premiums....The preexisting conditions mandate isnt a win. It is a loser for everyone. Now, everyone's premiums will be forced higher to pay for the sick. How many thousands of healthy patients do you think it would take to cover a single cancer patient when the insurance company not only HAS to enroll them, but cannot charge them in accordance with their current health? Instead of charging the sick guy 500 a month and charging me 50 a month, both of us will be charged 275 a month. Oh, and if cancer patient goes to the federal exchange for subsidies, the govt gets a say in how much care he gets.

You say you agree preexisting conditions need to be covered but you don't want the mandate. How can you have one without the other. Someone has to subsidize those with preexisting conditions or else their premiums would be unaffordable. If healthy people aren't forced to buy insurance, where will the money come from to pay for the less than healthy?