State capitals nationwide are debating whether to expand Medicaid as outlined by Obamacare. Gov. Rick Scott has stated that Florida will not accept the federal government's orders to do so, as others have.

This debate arose because of the U.S. Supreme Court's June ruling that the federal government cannot force states to expand Medicaid under the health care reform law.

The law's defenders say the feds will foot the entire bill for the first three years - and 90 percent of the tab thereafter.

But extending Medicaid to 11 million more Americans - as Obamacare intends - won't do any good if the newly covered can't find a doctor. And that outcome looks likely.

America's doctor shortage is worsening - just as millions more people are set to gain insurance coverage through expanded Medicaid programs and new federal tax subsidies.

DOC SHORTAGE IS REAL

According to the Association of American Medical Colleges, the United States will be short nearly 63,000 doctors by 2015. By 2025, that figure could double.

Medical schools are producing one primary care doctor for every two needed.

Nearly a third of doctors refuse to accept new Medicaid patients, according to a report from the Centers for Disease Control and Prevention.

The government pays below-market rates for Medicaid patients - between 34 and 42 percent below what doctors receive from privately insured patients. Some doctors lose
money on every Medicaid beneficiary they see.
By expanding the program to cover one in four Americans, Obamacare will only exacerbate this state of affairs.

It's no wonder that doctors are pessimistic about the law's impact on health care. Half believe that hospital closures caused by Obamacare will reduce access to care. And 83 percent of physicians foresee increased wait times for primary
care appointments.

Forty-nine percent of doctors under the age of 40 report that Obamacare will negatively impact their practices.

Some 43 percent of all doctors are thinking about retiring in the next five years - thanks in large part to the headaches created by health reform.

A BETTER ALTERNATIVE

Repealing Obamacare would stave off doctors from leaving the profession. By returning control over medical care to doctors and patients, repeal would make the medical profession attractive to America's best and brightest once again.

In Obamacare's place, lawmakers should allow individuals to purchase insurance policies with pre-tax dollars – just as businesses can. This would empower consumers to select
insurance policies that meet their needs. A new army of consumers shopping for insurance would inject competition into the marketplace and yield lower prices - simultaneously delivering universal access to coverage and reduced costs.

Such consumerism would also improve prospects for doctors.

Rather than running through third party payers, physicians could be upfront about the cost of medical care - and make treatment decisions collaboratively with their patients.
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Sally C. Pipes is president, CEO and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her latest book is "The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare" (Regnery 2012).

Source...Florida Times-Union, printed version, October 1, 2012