The Real Reason Your Doctor Dislikes Obamacare

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There aren't many laws as polarizing as the Affordable Care Act, better known as Obamacare. Since it was signed into law by President Obama in 2010, the ACA has been drawing a noticeable divide between optimists and pessimists that seems to grow wider with each passing day.

On one side are consumers who previously had no access to health insurance because of their income or a pre-existing health condition. For these individuals, Obamacare has been a welcome overhaul to the nation's healthcare framework as the individual mandate has required insurers to welcome these individuals into their member network with open arms.

On the other side of the equation are primarily younger adults who don't like the idea of being required to purchase health insurance that they will only minimally use. Though the premise of the ACA is to spread medical costs over a greater swath of the American public so as to reduce medical inflationary costs, people who oppose the individual mandate would prefer to have no part of it.

While this divide has been greatly publicized, an even larger rift could be developing within the medical community with doctors themselves.

Why your doctor really dislikes Obamacare
According to a report released last month by the Physicians Foundation, which surveyed more than 20,000 physicians and is released every other year, just 25% of those surveyed would give the ACA an A or B grade, while 46% would give Obamacare a grade of D or F. But, when push comes to shove, it really doesn't matter whether or not physicians like or dislike Obamacare, because it remains the law of the land one way or another.

Source: Flickr user

However, what does matter, and what was the front and center findings from the Physician Foundation's study, is that 81% of physicians described themselves as either overextended or at full capacity with regard to treating patients. This figure is up notably from 75% in 2012, and it demonstrates why physicians as a whole really aren't fans of Obamacare adding even more patients to their plate.

Furthermore, 44% of physicians noted that they planned to take one or more steps to reduce patient access to their services. Some of the methods they may employ include closing their practice to new members, working part-time, simply cutting back on the number of patients seen on a daily basis, or perhaps even retiring early. In fact, 39% of physicians surveyed indicated their intent to accelerate their retirement plans so they could retire early.

Why physicians are at full capacity
Why are the majority of physicians at full capacity, you wonder? There are actually a number of reasons.

First, the Affordable Care Act enrolled 8.1 million people in 2014, of which 7.3 million are still paying members. For those with preexisting conditions, as well as those who qualified for Obamacare under the Medicaid expansion in 26 of the 50 U.S. states, access to medical care is easier than it's ever been. In other words, doctors can probably expect the number of Obamacare enrollees heading to the doctor for preventative visits to increase in 2015 and beyond.

Secondly, right as ACA enrollment soars baby boomers are beginning to hit their retirement age. It's no secret that the older people get, the more likely they are to need regular medical care -- and that's worrisome news for our already busy hospitals and health clinics. With the first boomers retiring in 2011 and expected to continue hitting full retirement age between now and 2029, the number of Americans aged 65 and older will rise from just 13% of the total population to 20% by 2030. Of course, let's not also forget that Americans are living longer than ever, too, meaning potentially years of medical care that wouldn't have been accounted for when these boomers were born.

Finally, job growth for doctors in this country is anemic. Whether it's the long tenure required to become a doctor or the astronomical costs associated with the schooling, the growth rate of medical school graduates between 2002 and 2011 was a paltry 1.1% per year, from 15,676 graduates in 2002 to 17,364 in 2011 based on data from the Kaiser Family Foundation.

Source: Flickr user Frances1972.

Additional concerns exist as well
On top of many physicians being unwilling to take on even more patients, doctors are becoming increasingly choosey with regard to acceptable Medicare or Medicaid-based patients. Based on physicians' responses, 38%, or nearly two in five, either refused to see Medicare/Medicaid patients or limited how many government-sponsored patients they saw.

The reason behind this move is that Obamacare is slowly trying to pare back how much it divvies out to private businesses that rely on Medicare and Medicaid. In short, over time, these payments are likely to fall, leaving some physicians concerned that they won't be adequately compensated for services rendered.

What this means for you
For John and Jane Q. Public, this survey demonstrates that it could be difficult to find high-quality medical care in the not-so-distant future, especially if doctors are shy about taking on new clients. Realistically, it's not as if we're going to see our medical graduate rate shoot exponentially higher any time soon, so this is a reality many consumers may be forced to deal with.

Source: Flickr user Taber Andrew Bain.

What might actually happen is this clinical overflow could work its way into hospital emergency rooms. As you might imagine, the thought of that would have hospital giants like HCA Holdings and Tenet Healthcare licking their chops as a higher percentage of emergency room clients should be insured now, meaning fewer uncollected bills after service is rendered. Hospitals especially are counting on the ACA to help them collect more of their billed revenue since there will be fewer uninsured people left in the country. According to HCA, one of out every 22 ER visits is to one of its owned hospitals. 

But, even to this end, I worry hospital ERs may not be able to keep up with the increase in medical demand created by the overhaul of our healthcare system right as boomers begin to retire. Unfortunately, it's still too early to tell just how often last year's group of ACA enrollees will go to the doctor, and we likely won't have that answer for another year or two. For consumers and the healthcare investor, it means a lot of uncertainty is still yet to play out.

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