As we rush headlong into health care reform or whatever it is we are doing, one thing is certain. That is, we will increase the demand for health care services. If one believes the notion that people with no or inadequate health insurance forsake health care, then it stands to reason that once they obtain such coverage the demand for services will rise (and that in the absence of medical care management and malpractice reform these folks will be subject to the same level of over treatment and defensive medicine as the rest of us).
Not only does that not bode well for health care costs, who is going to provide that care and will the 255,000,000 Americans already covered find it more difficult to obtain care? There is already a declining number of physicians accepting Medicare patients, but that is not the real problem, it is the growing shortage of physicians in general.
This may well be one of the classic cases of unintended consequences; we rapidly expand coverage to 45 million more people, we lessen the individual concern for the cost of care and in the process will greatly increase the waiting time for health care and perhaps in some cases lower the quality of care as well.
Politicians have a knack for simplistically solving problems, i.e. the insurance companies set too high premiums and abuse the system hence, we will require them to accept all comers, we will approve their premiums and will expand coverage…problem solved!
Sadly, we may all learn that it is more like, problem created.
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