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Barrasso's 2nd Opinion: Obamacare Increases Doctor Shortage, Decreases Care

Law Delivers Coverage—Not Care

July 31, 2012

One of the central claims of President Obama and Washington Democrats was that the health care law would extend insurance coverage for millions of Americans.

As the New York Times recently pointed out, the President’s law delivers coverage, but not care. The doctor shortage in our country will now be even worse. The article highlights an Association of American Medical Colleges study, which found that in 2015, the country will face a shortage of over 60,000 doctors.

Today, U.S. Senator John Barrasso (R-WY) warned how this shortage of doctors will mean many Americans won’t have access to the medical care they need.

Excerpts of Senator Barrasso’s remarks on the floor of the U.S. Senate:

“Well, after practicing for 25 years, I understand that there is a huge difference between health coverage and health care.

“When people have a health insurance card, then they have coverage. When people have access to a doctor or a nurse or a nurse practitioner or physician assistants, then they can receive health care.

"The ‘New York Times’ actually pointed that out this Sunday morning, front page above the fold. They proclaim in the first paragraph of an article that the ‘President's health care law delivers coverage, but not care.’

“The story highlights a study from the Association of American Medical Colleges which found that in 2015, just three years from now, the country will face a shortage of over 60,000 doctors. By 2025 the shortage is expected to expand to approximately 130,000.

“The shortage of providers is very important because, as the article states, coverage will not necessarily translate into care.

“This is especially true for those individuals who are supposed to receive their health care through Medicaid. Remember, a huge expansion of Medicaid was a part of the President's health care law. It was part of the discussion in the Supreme Court, the decision they came out with. And Medicaid, of course, is the program that provides health care for low-income Americans.

“You’ll recall that the president's health care law contained one of the largest expansions of Medicaid in the program's history.

“The President chose to expand the program despite the fact that fewer than half of primary care clinicians would accept new Medicaid patients as of 2008. Fewer than half of primary care clinicians were accepting new Medicaid patients.

“But yet, that is where the President chose to build his health care reform from.

“So you say why is it that so many physicians, primary care physicians aren't seeing Medicaid patients?

“It’s because the reimbursements provided to doctors are so low that many simply can't afford to see Medicaid patients and continue to keep their doors open.

So the program that the President highlights is that one of the cores of his health care law is already in significant trouble. It is not functioning and is getting worse.

“So the state of Illinois has imposed a new limit on the number of prescription drugs that a patient can receive who is on Medicaid. This cap was imposed as part of a plan to cut $1.6 billion from the state's Medicaid program.

“Mark Higherman, Professor at the University of Chicago Law School, told ‘The Chicago Tribune’ that the prescription drug limits amount to a denial of service.

“That’s what we're looking at now, and yet this is the basis upon which the President has built his health care law.

“According to the most recent estimate by the Congressional Budget Office, over one-third of the people expected to gain insurance coverage under the President's health care law are supposed to do it through this Medicaid program.

“Clearly with states being forced to cut back their existing Medicaid programs, there are many people who are not going to get the care that they were promised through the President's health care law.

“For those who can find a physician, many of these patients will have to commute longer distances and will also have to endure longer waiting times just to get the treatment that they are seeking.

“Now, some experts have described this as an invisible problem, and they say that is because people may still get care, but the process of receiving that care will be more difficult.

“Now, the Chief Executive of the California Medical Association says it results in delayed care and higher levels of acuity—the seriousness of the injury or the illness to that patient when they finally get the care that they need.

“So when care is delayed, medical problems can become much more serious, and that forces patients to seek treatment through other settings an one of the prime examples of that is heading to the emergency room.

“The whole goal that I remember the debate here on the Senate floor listening to my colleagues on the other side of the aisle is that patients under the President's health care law, the Democrats claim, would be able to get to see a doctor, a primary care doctor, wouldn't have to go to the emergency room, but that's not what we're finding under the President's health care law.

“We’re finding just the opposite of what the President had promised.

“That’s why the American college of Emergency Physicians told the ‘Wall Street Journal’ ‘While there are provisions in the law to benefit emergency patients, it is clear that emergency visits will increase as we have already seen nationwide.’

“So, the President says one thing. The American college of emergency physicians is telling you what they're seeing on a daily basis in the emergency rooms across the country.

“Put another way, since the President's health care law exacerbated the shortage of providers, more patients are seeking treatment in emergency rooms.

“It’s not what the American people were looking for in health reform.

“So instead of making empty promises, supporters of the health care law should have dealt with the issues that are already causing many doctors to rethink their medical career.

“For example, supporters of the law refused, absolutely refused to deal with the crushing burden of medical lawsuit abuse.

“It’s an abusive situation that is forcing doctors to practice significant amounts of defensive medicine, which is very expensive—expensive for patients, individual patients, as well as expensive for the system.

“The Harvard School of Public Health found that these costs amount to 2.4% of annual health spending in the United States or $55 billion in 2008.

“Apparently supporters of the law thought it was more important to help trial lawyers instead of patients.

“Finally, many people choose to become doctors because they enjoy being able to innovate and create the next generation of devices and treatments.

“Unfortunately, that is changing as a result of the significant taxes that are part of the health care law.

“In an article published on Friday, we have learned that Cook Medical, which is a medical device company in Indiana, announced that it was scrapping plans to expand because of the President's health care law.

“The Senate should also know that this Cook Medical company produces medical devices that address women's health issues. Specifically, the company produces products related to gynecologic surgery, obstetrics and assisted reproduction, just to name a few.

“Therefore, the President's health care law is actually hurting the ability of Cook Medical and other companies to provide American women with access to cutting-edge medical technology.

“Why? Because of the device tax, which I believe we should repeal the entire law, but clearly we have introduced legislation to repeal the medical device tax. It is a bipartisan piece of legislation supported from both parties and should be passed immediately.

“As I have been saying for a number of years here on the Senate floor, coverage will not necessarily translate into care.”