Healthcare and the Supply Chain: The More Things Change the More they Might Stay the Same

This morning we welcome back Lynn James Everard, a voice of both expert and objectivist commentary around the US healthcare debate and its Spend Management implications for the country.

President Obama has won a major political victory in the passage of a healthcare bill -- a healthcare bill does not, however, automatically become healthcare services for 31 million uninsured. For starters, those 31 million people will need doctors to care for them. Yet a mere six days from today, on April 1, 2010, the 21 percent cut in Medicare reimbursement for doctors (originally passed in 1997, but delayed every year since then) will go into effect with no congressional action. Congress had meant to deal with it, but could not put the $250 billion price tag (over ten years) within the healthcare bill: otherwise the healthcare bill wouldn't have appeared to cut the deficit over ten years.

Also, perhaps dealing with it on the heels of the healthcare bill would make people realize that it should have been in the bill all along. But in "politics first!" DC, things only seem to make sense if they make sense politically. The AMA, a strong supporter of the healthcare bill, has a countdown clock on the Medicare reimbursement cut on their website. If it is not addressed soon, many doctors have indicated they will stop accepting Medicare patients or perhaps even retire early, heightening an already troublesome physician shortage.

The President claimed that the healthcare bill would unclog hospital emergency rooms by having the sick but not critically ill be able to be seen at a doctor's office. If there aren't enough doctors available in 2014, however, then hospital ERs could become even more overused than they are today. The healthcare bill will address the issue of insurance coverage, but coverage without access is not healthcare. Legislating the coverage is the easy part. But how do you legislate access if the demand for care exceeds the supply of primary care providers? That is the real question and the one on which President Obama will ultimately be remembered and judged. He appears to be taking his victory lap about five years too soon.

Note: The views expressed here are those of the author only and do not represent the views of any other person or organization.

Lynn James Everard

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