With the recent bill that's currently being debated within the Senate, ultimately it comes down to providing a little over 30 million underinsured or uninsured people to have access to care. The problem with that is it still leaves between 11 and 15 million people not having care.
So, have we truly moved the needle in providing healthcare reform? I would say no. A couple of reasons for this:
- By providing access to care for an additional 30 million people, no one has really thought about where are those people going to go in today's environment? The assumption is today that most of these people who are underinsured or uninsured seek care primarily in the emergency rooms. If now they are given access to care through primary care or traditional methods, currently we do not have enough primary care physicians to treat those already insured. Adding another 30 million people to that pool will surely overwhelm the primary care physicians.
- With the reform bill that's being debated today, cuts are being made to the Medicare payment system, and when you do that more and more providers, especially primary care physicians, will no longer seek or treat Medicare patients. So we'll have an exit of the primary care physicians once this passes, and we already have a shortage of primary care physicians.
It's important to note that in medical schools today, only five percent of students go into primary care. The feeling is that once this reform bill is debated, and the final details are communicated, that number of 5% will go lower once people realize the magnitude of not only the patient volume but also the ability to make money on these patients will be minimal.