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Nat Hentoff: What Obamacare can do to you - not for you

Posted: August 7, 2013 2:00 a.m.
Updated: August 7, 2013 2:00 a.m.

r. Tom Delbanco, a professor of general medicine and primary care at Harvard Medical School, approves of certain sections of Obamacare, but raises a critical matter that has been largely unreported about primary care doctors, whom he describes as "the pediatricians, family doctors and internists who constitute the foundation of our medical system" ("Will Obamacare help primary care?" Delbanco,, July 23).

He worries that "as the new health care exchanges offer affordable insurance to more and more Americans, there is risk that a flood of new patients may overwhelm the already-besieged primary care workforce."

Since Obamacare’s health care cost-cutting rules do not focus on the differences among individual patients, Dr. Delbanco makes a point that We The People must keep in mind as Obamacare takes over many of our lives:

"Numbers such as blood pressures, sugar or lipid levels tell only part of the story for individuals whose genes, cultural habits, psyches and social circumstances vary widely."

Gathering this information will be a waste of time and costs in the Obamacare system.

But as I can demonstrate from my own experience with my longtime primary care physician, his focus on the individuality of his patients keeps strengthening the quality of my life.

So I was not surprised to see this report from Tom Howell Jr. in The Washington Times: "The United States needs 16,000 more primary care physicians to meet its current health needs, a problem that will only get worse if nothing is done to accommodate millions of newly insured residents under President Obama’s health care law in the coming decade.

The report notes the shortage is most acute in rural areas and urban inner cities.

The health care expense problem and the vanishing of primary care doctors do not, of course, affect President Barack Obama personally. But he sure has limited the availability of health care — and actual survival prospects for many of us — while changing the future professional careers of a growing number of doctors.

A recent health care survey conducted by the Deloitte Center for Health Solutions notes, "Six in 10 physicians say that it is likely that many physicians will retire earlier than planned in the next one to three years. This perception is fairly uniform among all physicians, irrespective of age, gender or medical specialty."

According to the Deloitte survey: "Physicians recognize ‘the new normal’ will necessitate major changes in the profession that require them to practice in different settings as part of a larger organization that uses technologies and team-based models for consumer (patient) care."

And furthermore: "Nearly three-quarters of physicians (higher among surgical specialists at 81 percent) think the best and brightest (students) may not consider a career in medicine ... while more than half believe that physicians will retire (62 percent) or scale back practice hours (55 percent) based on how the future of medicine is changing."

That is understandable. In an interview with World Net Daily, "a spokeswoman for the Association of American Physicians and Surgeons, Dr. Jane Orient ... told WND that doctors already have started leaving the profession through early retirement.

Dr. Orient told WND’s Bob Unruh: "I think it’s a disaster for patients. They may lose the doctor they relied on all their lives."

Orient was quoted in the article affirming "many doctors are unable to continue a private practice and will end up working for a corporation hospital where the profits are distributed to shareholders.

"She warned that such scenarios often end up giving the feeling of an assembly line, where a patient sees a doctor briefly, is given a diagnosis and shown the door.

As a voter in future congressional and presidential elections, how much time will you spend carefully fact-checking candidates’ records fighting what Obama has done to turn more of our health care system into cost-efficient assembly lines rather than personal patient-care services?

Nat Hentoff is a nationally renowned authority on the First Amendment and the Bill of Rights. He is a member of the Reporters Committee for Freedom of the Press and the Cato Institute, where he is a senior fellow. His column is copyright 2013 by the author and distributed by Universal Uclick for United Feature Syndicate.


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