Paging Dr Fine...

Let me tell you what happened to me on this last Monday. My blog was very late that day because I was at an Urgent Care center. I got there at 11am.

I was taken into exam room at 1pm.

Doctor came in at 1:45pm

I was out the door by 2:30pm because it was a lot serious in the end that I thought it was.

But what I am focusing on is that an “Urgent Care” facility had this long wait because they were short staffed for doctors I heard. They only had 2.

And waiting room full of people.

Then I started to hear about doctor shortages and the Health Care reforms that will short Doctors on their payments and making no less bureaucratic than it is now. Probably even more so.

I have already said one of the real reforms need is Tort Reform, where the doctor doesn’t run unnecessary and expensive test just to be pararnoid that if they don’t run it somewhere down the line they’ll be sued for not running them

This drives up the costs.

Then I ran across this article about Canada’s health care and the long wait times due to doctor-patient ratios.

The Hill: After more than a decade of public healthcare with mandatory coverage, so many Canadian doctors have left the practice and so many young people have entered other fields that Canada ranks 26th of 28 developed nations in its ratio of physicians to population. Once, Canada ranked among the leaders in the number of physicians, but that was before government health care drove doctors out of the practice in droves.

The fundamental fact is that we cannot cover 36 million new patients without more doctors and nurses, much less with the declining census of medical professionals the Canadian experience points to. A recent survey of doctors by the Pew Institute found that 45 percent of all practicing doctors would consider retiring or closing their practices if the Obama healthcare bill passes. This scarcity of medical personnel heightens the likelihood of draconian rationing, lengthy waiting lists and lower-quality medical care for all of us, particularly for the elderly.

This physician shortage leads to massive and never-ending waiting lists. In 1993, for example, there was an average wait of 9.3 weeks from the time a patient got a referral from a general practitioner to the time he could see a specialist. By 1997, the wait was up to 11.7 weeks. Now it’s 17.3 weeks — over four months just to see a specialist!

In Canada, unions control the entire healthcare process. In Manitoba, for example, there is an eight-month wait for colonoscopies, yet the unions do not permit weekend or evening procedures, thereby extending the waiting lists. The unions are doing to health care in Canada what they have done to education in America: stifling creativity, reinforcing bureaucracy and extending waiting times.

Because of these long waits for colonoscopies, there is now a 25 percent higher incidence of colon cancer in Canada than in the United States. And because the leading drugs that we routinely use to treat the malady in the U.S. are banned in Canada because of their high cost, 41 percent of Canadians who get the cancer die of it, compared with only 32 percent in the United States. Overall, the cancer death rate in Canada runs 16 percent higher than in the United States. Cancer does not wait for waiting lists to clear.

The proposed $400 billion cut in Medicare raises the probability that more and more of those doctors who do practice will refuse to accept Medicare patients, aggravating the doctor shortage among the elderly, the population that needs them the most.

Utopia awaits!

UK Telegraph 4/2009: “We’re not producing enough primary care physicians,” Mr. Obama said at one forum. “The costs of medical education are so high that people feel that they’ve got to specialize.” New doctors typically owe more than $140,000 in loans when they graduate.

And paying them less, and leaving malpractice insurance and paranoia of law suits, not to mention a Bureaucrat in Washington making decisions for them, sure sounds like a good career path to me.

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.”

So that where the so-called “doctor fix” comes in. You bribe them with an “off the books” bribe of $250 million dollars so that it’s not counted in the 1 trillion plus accounting legerdemain that both houses of Congress are engaged it.

If we don’t count it, it won’t count. Magically disappearing debt!

Simple, right?

Democrats plan to make ObamaCare “deficit-neutral” by moving nearly a quarter-trillion dollars off the books, one of the great fiscal deceptions of the century.

In January, doctors fees are scheduled to fall by 21.5%, and 40% over the next five years. That would force many doctors to stop seeing Medicare patients, so Congress intervenes every year and temporarily overrides the cuts.

But now they are going to cut as much as $500 million from Medicare to pay for the new Albatross on the block. But to do that means even more cuts, so very likely, less Doctors to treat you.

So we have the fix of the century. And it doesn’t count.

And it’s not their fault.

Self-interest is more important than principles.

Hill: The drug industry backed ObamaCare and, in return, got a 10-year limit of $80 billion on cuts in prescription drug costs.

WSJ: The American Medical Association’s asking price for supporting ObamaCare is scrapping the SGR (Created in 1997, the SGR slashes Medicare reimbursements if costs rise too steeply, as they always do).

So now Democrats are simply going to “untether” this spending on doctors from ObamaCare, hiding even more of its true costs. At a meeting on the Hill last week, Mr. Reid and White House Chief of Staff Rahm Emanuel made the quid pro quo explicit, telling the AMA and about a dozen specialty societies that in return for this dispensation they expect them to back ObamaCare, no questions asked.

The AMA does support Obama. As does AARP.

The Hill: The AARP got a financial windfall in return for its support of the healthcare bill. Over the past decade, the AARP has morphed from an advocacy group to an insurance company (through its subsidiary company). It is one of the main suppliers of Medi-gap insurance, a high-cost, privately purchased coverage that picks up where Medicare leaves off. But President Bush-43 passed the Medicare Advantage program, which offered a subsidized, lower-cost alternative to Medi-gap. Under Medicare Advantage, the elderly get all the extra coverage they need plus coordinated, well-managed care, usually by the same physician. So more than 10 million seniors went with Medicare Advantage, cutting into AARP Medi-gap revenues.

Presto! Obama solved their problem. He eliminates subsidies for Medicare Advantage. The elderly will have to pay more for coverage under Medigap, but the AARP — which supposedly represents them — will make more money.

Feel those bus tires on your back yet? Or are the knife wounds getting in the way?

It turns out the AMA is a cheap date. President J. James Rohack now looks ready to embrace whatever else Democrats offer up, even though the new bill only delays the SGR cuts for 10 years instead of doing away with the formula permanently. Never mind that the AMA’s other legislative priority—tort reform—is dead on arrival. ObamaCare is stocked with other provisions that punish doctors, such as a Medicare commission tasked with cutting spending but barred from raising the eligibility age or reducing benefits. In practice, this means it will only be allowed to crank down Medicare’s price controls on providers.

This doctor maneuver is such a cleverly dishonest solution to their many contradictory promises that we’re surprised Democrats didn’t think of it sooner.

So these endorsements are not freely given, but bought and paid for by an administration that is intent on passing its program at any cost.

Evil Capitalism Alert: When the supply goes down and the demand goes up– What happens to the price?

Ironically, just a little more than a decade ago, there was a doctor surplus. In 1996, a committee of the Institute of Medicine warned that the United States had a surfeit of doctors caused by foreign-trained physicians coming here to work and recommended freezing med-school class sizes and limiting first-year residency positions. A year later, Slate ran an article on an alternative strategy for reducing the number of doctors approved by the federal Health Care Financing Administration. Under the Graduate Medical Education Demonstration Project, 41 teaching hospitals received $400 million in exchange for not training between 20 percent and 25 percent of the medical residents they would otherwise have trained over the next six years.

According to some estimates, the demand for doctors will rise to between 1.09 million and 1.17 million by 2020—many tens of thousands more than we’ll actually have.

So, Paging Dr Howard, Dr. Fine, Dr. Howard!

“Sorry they can’t see you”

You’ll just have wait for Dr. Gov-Cheap N. Easy.

How does February sound?