Will your doctor accept "Obamacare"?

It is true that "Obamacare" (properly referred to as the ACA) has shrunk payments to physicians so much that some doctors cant afford to accept the insurance coverage. Many are wondering WHY this is happening, dont doctors make enough to budge a little? I will tell you why & answer that in this post.

For a typical quick patient visit, a private insurer might pay $100 while Medicare would pay around $80. And ACA subsidized plans are more likely to pay closer to $80, which is unsustainable for the average hometown medical practice. It makes the scales tip heavily toward lower reimbursements overall.

“I cannot accept a plan [in which] potentially commercial-type reimbursement rates are now going to be reimbursed at Medicare rates,” Dr. Gerard, an internist from Connecticut, told NPR. ”You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on.”

The same is true no matter where you live, and right here in Merced, Ca it is ESPECIALLY true. The majority of children have been rolled off of a great insurance program called Healthy Families, and onto the state controlled Medi Cal. That was MOST of Merced Counties kids, just overnight dumped into the government system! For every kid seen in a clinic, the doctor is already discounting his services significantly just to accommodate.

When you consider that a family making $80,000 per year COULD still wind up on Medi Cal, you've accounted for almost all of Merced, where there is a median household income of $43,000. At any given time of day, the clinic seats are full of either kids or elderly. The Dr has to find a way to "keep the lights on" with $80 each.

If you think of this from the doctors point of view it goes something like this:

"I went into business thinking I'd have a nice, clean office where people didnt have to wait 3 hours to be seen, where I didnt have to go without lunch because a patient was in the waiting room in pain and I couldnt stand to turn them away. I wanted my office to be a place where I could provide important health benefits to my employees, plenty of vacation and sick days. I can't do that at all with the new health care act. All of that goes away, and I end up having to take in more patients per day to achieve just making payroll. This makes for the experience that I did NOT go to school 10 years for." (I compiled that from talks with several Dr's cant site just 1).

Yes, we know that doctors make a lot of money. We see their cars and houses. They went to school for TEN YEARS to earn that kind of life for the woman they fell in love with, the kids they would raise and want the best for, the grandkids who they will want to spoil a little bit. The employees whose lives would change if they could provide benefits, good wages and vacation time... the communities they dreamed of "Giving Back" to.

I know where my Doctor's money goes. He adopts kids, he donates it to schools, he attends high school football games and brings his medical bag and runs up and down the sidelines in hus scrubs trying to see EVERY SINGLE TACKLE in case someone is hurt he can see exactly how it happened. Then he treats them on the spot, sews them up or tapes them up.

That is what my Dr does with his money and time, and I am all for supporting his comfy living room with designer couches if he wants them. He must be very sore and weary when he gets home. And, get this, he does accept the Obamacare insurance for anyone who was a patient of his prior to the ACA. He didnt kick out a single family. His income will decrease, he will have less to donate, he will have to work more hours and volunteer less often. Will the next doctor to open up a practice be able to make these sacrifices? I don't know. I do know that more and more doctors will have NO choice, and eventually they will all take the ACA insurance plans. But its going to take some time for them to adjust. They are hanging onto their dream just like we hang onto ours. They are human too. In closing, I will tell you my biggest fears about the ACA, because you are used to hearing me tell you what I think before I close out of a blog. My biggest fear is for our American Medical Schools. They come at hefty prices to attend. Once a doctor is out of medical school, he has to pay off all that debt! Now, cross over the sea to India, for example. Or Brazil. The doctors go to school for free over there, then they come over here to work. They can afford to take the lower wage because they dont have to offset medical school costs. This leaves our own American doctors in a tough spot to compete and survive in the medical field. I fear the America I see ahead where there is NO hope for our own children to become Doctors, if that is their dream. Where there is no hope for finding a Dr who can speak my language first, and truly understand my medical concerns, or that I cant understand his recommendations for my treatment. I sure hope we do something to keep our American Doctors in the running. I truly appreciate our foreign doctors, but I do not want to give up an industry completely, the way we have given up most of our industry in the USA.

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Executive Edge Insurance Services

3061 College Green Dr Suite A Merced Ca 95348

209.385.3343    CA LIC 0F37811, TX LIC 2483887

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