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Obamacare And Doctor Shortages

Sitting in the packed waiting room of my doctor’s office, I imagined health care in the future.

Visions of sleeping bags danced in my head.

With a 650-doctor shortage and rising, in 2014 how many People magazines will I have to read or meals will I miss before the nurse calls my name?

I have a phenomenal doctor at Pali Momi, but there was a time when I struggled to find a primary care physician. Many doctors weren’t taking new patients or didn’t accept my insurance.

I get the need for reform. Americans should have access to good, affordable health care.

But like many who opposed the passage of the Patient Protection and Affordable Care Act (Obamacare), I question both whether it is affordable and whether it will stretch providers to the point that care will not be good.

The Supreme Court correctly labeled Obamacare a tax, meaning we pay more for care, it will cost $1.3 trillion in deficit (unaffordable) spending over 10 years, and 30 million new people will become insured in 2014. Need I mention a national debt of $16 trillion and growing, a crippling budget deficit and a flat economy?

But the pressing question is: Where are the doctors who will treat the 30 million this law newly insured?

“It’s hard to recruit to Hawaii because the cost of living, as well as the cost of practice and reimbursement, is a bit lower here in Hawaii than elsewhere in the nation”

In the July 28 New York Times article “Doctor Shortage Likely to Worsen With Health Law” by Annie Lowrey and Robert Pear, the Association of American Medical Colleges reports that in 2015 the country will fall short by 62,900 doctors, “and that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care.”

And, since “it takes a decade to train a doctor,” there is little the government or medical pro fession can do by 2014, when the law kicks in.

Right now Hawaii faces both financial and physician deficits.

In five years the island of Hawaii will lose 32 percent of its current physicians, according to a survey published in the April Hawaii Journal of Medicine and Public Health. Its deciding issues are “financial sustainability, professional opportunities, community support and access to good K-12 schools,” according to a report by Karen L. Pellegrin, director of continuing/distance education and strategic planning at the University of Hawaii at Hilo College of Pharmacy.

In his May 2012 remarks to the 64 new doctor grads of the University of Hawaii John A. Burns School of Medicine, dean Jerris Hedges encouraged grads to return to Hawaii to practice medicine because they are needed here.

“It’s hard to recruit to Hawaii because the cost of living, as well as the cost of practice and reimbursement, is a bit lower here in Hawaii than elsewhere in the nation,” says Hedges in a May 13 HawaiiNewsNow.com article, adding that they’re able to recruit back about half of those who leave for post-grad studies.

But even if 35 doctors a year return to Hawaii, it can’t keep pace with the attrition rate of retiring and exiting doctors. In a 2011 article by Hedges and Dr. Kelley Withy, “Boosting Number of Doctors in Hawaii is Critical Need,” findings from the physician projections firm, The Lewin Group, revealed that Hawaii is currently “short more than 650 physicians and if we don’t take action, we could double our shortage by 2020.”

That’s just seven years away. Hawaii’s great climate, nice people and the beautiful ocean can’t offset the high cost of living, bad business climate, low-ranking K-12 schools and high malpractice insurance costs when it comes to attracting and keeping superior doctors.

In my opinion, this doctor crisis is a crime against the Hawaii people. Decisions that have been made by our Legislature for years are the cause. The state’s wasteful spending projects, an unfriendly business climate, the egregious General Excise Tax on goods and services, other high taxes and fees, a top-heavy school system and special interest “bargains” to buy union loyalties are directly related to our sky-high cost of living, low-rated schools and why we can’t retain doctors or attract businesses.

We now see how these reckless, self-serving practices by lawmakers directly connect to the very most fundamental measure of any successful community: a healthy population.

If we don’t change our ways, Hawaii needs to brace for an illness for which there will be no cure.

Are you ready for long waits for appointments, long waits to see doctors, bureaucrat health panels to determine who gets treatment, and higher costs?

I already have my sleeping bag ready.

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