It makes sense... people who couldn't get insurance and sat at home sick rather than getting treatment will be able to go to the doctor now. Really though, there has been a growing doctor shortage for a long time and it is going to keep getting worse with or without Obamacare. Blame it on the old people.

For what it's worth, several provisions in Obamacare are aimed at alleviating this. I don't think they can make much of a difference, though. We just need more doctors.

We need to hurry up and start letting computers take a lot of the load off of human doctors. AI systems like Watson can probably already diagnose as well as or better than many human doctors. Human communication is still important, but much of that is done by PAs and nurses already.

like 30 million more people are going to have health insurance that didn't

we already have a shortage, does it not make sense it will become greater after ACA?

although the ER load will drop with an increase in PCP and specialist care needed for those of us with pre-ex conditions who now can get care. are there any sources out there that estimate the shift in numbers? regardless of any of this, more doctors are needed i don't think that is in question

an example of a goodie would be expensive care coming at the end of a person's life. We'll need to reign that in at some point in the future.

But I already have good corporate health insurance so **** those 30 million who are going to be fighting over my PCP right? They should have planned better. Unfair to change the rules of the game at this point when I'm winning.

ZOMG DEATH PANELZZZZ

and is the CBO estimate taking that into account? i would imagine if millions of people start getting proper care, then millions of people will be in better health and thus exponentially more productive over their lifetime. this would also maximize efficiency in the businesses these able-bodied people work for. and eliminate bankruptcies by medical bills which are a huge drain on the economy in multiple ways

I don't think you're understanding what I am saying. I am trying to say that we need the death panels, but any politician that tries to implement something like that is going to have a really difficult time. Probably the rationing will come in some other less efficient way.

i'm not arguing against it if that's what you think. i'm just trying to better understand the ACA

in my FB thread i actually stated that the doctor shortage was kind of a good thing because it will force USA to address the issue and create jobs in the medical field...not really sure why we haven't yet

It should be pretty obvious to you, but increasing access to health insurance is going to increase demand for doctors. There aren't going to magically be more doctors, and we're short already now.

It's not to be blamed on old people. It's to be blamed on doctors themselves. Various groups (AMA, AAMC) who accredit medical colleges decided in the 1980s that we'd actually have too many doctors in the future. Worried about losing pay, a new medical school didn't open until ****ing 2011 (Oakland University in Michigan).

Several new medical schools are opening (South Carolina, CMU, WMU and a few others), but then there needs to be more residency slots. There also needs to be a change in medicare reimbursement rates, because they heavily push people away from specialties that are desperately needed.

Yeah, that's what I was getting at. There was a sort of doctor shortage already in place, and it was projected to worsen over time, regardless of the ACA.



Sure, the ACA will add to the problem, but it's not the reason the problem exists.

I was going to come around to this. The shortage existed before the PPACA was passed and it was going to be getting worse without the passage of the ACA.

The doctor shortage isn't caused by the ACA anymore than it's been alleviated by increasing numbers of uninsured over the last 20 years or so. We have a doctor shortage because US medical schools don't graduate enough students and those who do graduate flock to high-paying specialties in urban areas over the less remunerative and rural ones.

That and the aging of the population are the proximate causes of the shortage, not insurance trends in the US. (The ACA does, in fact, have a few carrots that are intended to alleviate a small portion of this burden, including increasing scholarships for residencies in high-need localities and primary care specialties)

But the question at hand wasn't if the ACA caused the shortage, but if it exacerbates the shortage. The latter is obviously true.

My cousin and I have been emailing politics back and forth ever since I contacted him about the weird GOP voting statistical anomaly. Anyway here's his take on Obamacare. I told him the Cadillac plan doesn't kick in until 2018. But doesn't anyone know what he's talking about with the W-2 stuff, or increased taxes?

W-2 stuff = pure bunk. You report it but it isn't taxable or counted as income.

http://www.snopes.com/politics/taxes/HR3590.asp

That is not "stupid", that is literally the whole point of the Cadillac plan thing. People have plans that are "too good" because of some of the quirks of health care economics and the tax treatment given to health insurance, so they negotiate these nice plans and then overuse them because they aren't price sensitive. The Cadillac plan penalty is to push them back into negotiating more reasonable coverage.

I'm not sure what he means by "a tax on our health care benefits", other than the Cadillac plan tax. Here are the revenue sources from wikipedia:

My cousin makes a lot of money. So he'll probably get hit with the high earners part.

lol no.

The PPACA makes key investments in primary physician training, as well as in nursing and dental.

Here's a sampling:

Additionally, my 95 year-old grandma recently passed away, with sound mind up until the day she died.

What impressed me was that her excellent health care (Medicare) was provided almost exclusively by foreign-trained doctors, except for the hospital's Chief Medical Officer. She was cared for by a Russian doctor and 2 Indian doctors (maybe 1 Pakistani). The care was first-rate as far as I could tell. So, my guess is that if there is any shortage, after factoring in the additional PPACA funding/training, then foreign-trained doctors can and will make up the difference.

And I don't see any shortages myself. I can see my doctor usually the same day for emergencies, or they will have me see another one if he is unavailable. Of course, scheduling a physical takes a couple of months.

Also, funny, and sad, that we can go to Snopes to debunk nonsense when it is for something as serious and important as health care.

Is being fat a preexisting condition?

FYP

Just like seat belts. We can split what govt run means, whatever. Federal govt has pays 40+% of total USA health care costs already so what? It might all work out just fine. We'll see. Your implication that the govt regulation of the health care industry is about the same as regulation of the auto industry is silly (although in my view the auto industry is highly regulated but not nearly as much). Govt has a role to play in regulation, I never said otherwise. Let's not pretend that this the federal govt hasn't increased it's regulation of the health care industry substantially.

The Patient Protection and Affordable Care Act – Improving the Health Care Workforce: “Physicians, Nurses, and Dentists” – Third in Series

Yeah but emergency rooms now though often have long waits and a lot of those folks will be needing doctors when the law fully kicks in. Again the law may work fine. I have serious doubts that the federal govt will meet the challenges that implementing and administering this law presents. For instance there are a lot of states that are not going to establish exchanges and thus the federal govt will establish the exchanges in those states. I have my doubts that the federal govt is up to this task.

There are a lot of states for which the federal govt should establish the exchanges instead of the state, like almost anyone currently beset by a GOP-controlled state govt.

Let me ask you this. You are not sure that the govt is up to the challenge of implementing this law and health care, generally.

So, do you think that the US Govt is up to the job of implementing our military and national defense?

Do you think the US does a good job at implementing national defense compared to other countries?

Why would the US Govt suck at providing health care but be known by Trace Atkins and other policy wonks as pretty damn good at implementing the military and national defense?

Man, for a group of people that absolutely LOVES ranting about the importance of INCENTIVES, conservatives are remarkably uninformed about incentives in the health care market.

1. In a fee for service model, hospitals and doctors are incented to provide infinite treatment because it makes them more money. Conservatives have no interest in addressing this problem. Think it doesn't matter? Read this:

http://www.newyorker.com/reporting/2...a_fact_gawande

2. When individuals have low or no deductible coverage, they have little or no incentive to moderate their consumption of health care. Similarly, people with no coverage or poor coverage don't go to the doctor when they get sick, ultimately costing the system more. Again, conservatives don't have any answer to this problem. It's ZOMG SOCIALISM or "go to the emergency room." Awesome plan guys!

3. Insurance companies are in business to make money. Therefore they are incented to sign up healthy young people and run like the plague from older, potentially unhealthy people. The result is that the latter group can't get private insurance. Again, conservatives don't care and have no plan.

Do not listen to conservatives on this issue. THEY HAVE NO ****ING CLUE.