[ilovetv]

Originally Posted by blueash

Hopefully this will not be deleted as political, but you completely misunderstand the workings of the ACA. The ER's are in part overcrowded because people DON'T have insurance. ER's are required to provide evaluation without regard to the financial coverage of the patient. So the uninsured use the ER for primary care and minor illnesses. We still hear people say we don't need universal health insurance as poor people can get great free care in the ER, so everyone really already gets needed medical care. Once people have insurance, they will be able to go to primary care doctors and NP/PA's and not overcrowd the ER, and in fact get their care at much lower cost per incident. The ACA will hugely improve the ability of ER's to return to their mission of providing emergency care.

Wrong. An insurance card is of no use when there is no primary-care doctor to able to take on more patients, and they are quitting practice because Medicare reimbursements are already so low (and Medicaid payments are half of Medicare payments) they can't pay the bills and themselves and stay solvent.

When people with an insurance card can't get a primary doctor, or they cannot wait a week or two with the problem they have....or they do not WANT to wait a week to see the dr. they have....they go to the ER. And that is fact. And it's why the ER's are so full and will continue to be so, regardless of ACA coverage.

"A recent Senate report said the country is short about 16,000 primary care doctors – and that shortage is only expected to grow.

That's especially troubling for people in the public health and medical fields, since a soon-to-be-enacted provision of the Affordable Care Act will extend Medicaid to millions of Americans – begging the question of who, exactly, will treat them.

A recent study in the Annals of Family Medicine estimated there are nearly 209,000 primary care providers in the U.S.

That's a big number, but with population growth, aging and the changes brought on by the Affordable Care Act, experts say today's shortage of 16,000 primary care physicians will grow to about 52,000 by 2050.

That's also a big number – but it's a bigger problem.

Why the shortage of primary care doctors?

Dr. Felix Aguilar, the president and CEO of UMMA Community Clinic in South Los Angeles, says the primary care physician is a "jack of all trades but master of none."

"The role of primary care is to provide comprehensive care that is affordable, prevention-based and that looks at all the faces of a human life – from babies to grandmas," he said.

Dr. Aguilar is a practitioner of family medicine – one form of primary care. He's worked in underserved South L.A. for about 10 years, and loves what he does.

But Aguilar says there are a few things about the job that keep a lot of young medical students away. For one, they have a heavy patient load.

"We have less support," he said. "We're not hospital-based and, of course, we get less money, so those are the drawbacks."

Primary care doctors typically earn less and and get less support than doctors who choose to go into specialized fields: cardiology, neurology, podiatry, oncology and other specialized fields. Specialists also tend to work with fewer patients.

Add to that an average medical school debt of more than $160,000, and it's easy not so hard to see why a more lucrative field – that is, one that isn't primary care – would be so attractive to medical students....."

Primary care doctor shortage creates critical void, leaving field's future uncertain | OnCentral | 89.3 KPCC