A recent article in the New York Times (July 19) highlighted some major issues regarding the Affordable Care Act (Obamacare). The article was provoked by an essay in the Journal of the American Medical Association which emphasized some of the act's weaknesses.
Affordability remains a major problem, according to this discussion. It was thought that competition would help keep premiums affordable, but this has not been the case. The government is now considering adding a "Medicare-like public plan" to the mix. Private companies, however, already unable to sustain Obamacare requirements, would be even more likely to leave the plan with the adoption of a Medicare option which would significantly reduce the private marketshare by virtue of the invocation of a government controlled price option. Medicare would decrease physician reimbursement as well as hospital reimbursement.
A problem rarely discussed remains the one of physician availability in Medicare plans. More and more physicians, dismayed by lower reimbursement rates, are opting out of Medicare. This seems to be particularly true in urban centers. The Wall Street Journal reported that 9539 physicians opted out of Medicare in 2012 compared with 3700 in 2009. A recent study (2015) from the Kaiser Family Foundation surveying non-pediatric primary care physicians found that only 72% of the physicians are taking new Medicare patients, whereas 80% are accepting new patients with private insurance.
Medicare, the "safety-net" for senior citizens, is slowly losing physician-subscribers. This, too, requires addressing. Lowering reimbursement rates even further to bolster Obamacare will only tend to hasten this physician-departure.