The PPACA addresses only one of the healthcare shoes. It’s concerned with how healthcare is paid for, increasing access to healthcare insurance. Actually, that’s the easy part. The hard part is increasing access to care. The PPACA did nothing to change how healthcare is provided and that second shoe will drop soon. The Boston Globe explains the implications:
Across Massachusetts, about half of primary care doctors aren’t taking new patients, according to the Massachusetts Medical Society’s 2013 Patient Access to Care Study. The rate for internal medicine specialists, or internists, who often also serve as primary care doctors, is 55 percent. If you’ve found a new doctor and want to schedule a routine visit, be prepared to wait. It takes an average of 39 days for new patients to get an appointment with a family physician and 50 days to see an internist. That’s better than last year, when the average wait was a whopping 45 days, but up from 29 days in 2010.
The wait could get longer. The Association of American Medical Colleges projects that nationwide 13,700 more doctors of all types were needed than were available in 2010, and that the gap will hit 130,600 by 2025, with about half of the shortfall in primary care. Are doctors becoming two-headed calves? No, but they are getting scarcer, for lots of reasons.
Among the reasons are more old people, Baby Boomer docs retiring, the increasing tendency towards specialization, and greater demand induced by the PPACA.
If you think the battle over the PPACA has been hard-fought, you ain’t seen nothing yet. We need to make basic changes in medical education, licensing, and how medicine is actually practiced to increase the availability of primary care.