Use it or lose it. This principle holds for vacation days and muscle training. And now it will be true for millions of people entering the health care system under the Affordable Care Act.
For the first time, more than 30 million Americans will be able to access the medical care that many of us with insurance have taken for granted. A yearly physical with their PCP. Semi-annual dental cleanings. Regular neo-natal care.
But there are a host of elective medical services that I’ve had the privilege to access that aren’t so routine. Without thinking twice. That includes visits to my chiropractor and a visit to my orthopedist for an extra-tight hamstring. These services were covered under my health insurance.
And as millions who have been without insurance (or who have simply been underinsured) sign up for care under the new health exchanges, they will have broad access to a wide array of health services … causing an unparalleled demand.
Yet, where there is demand, one needs supply. Herein lies the rub: Even before the ACA went into effect, there was a growing need coupled with a fixed supply of care options. The Baby Boomers began reaching retirement a decade ago and add more strain to the health care system. Medical schools have continued to graduate only a fixed number of doctors each year. In fact, in the last half-century only one new medical school has opened in this country. And the physician population is aging rapidly. The American Medical Association found that nearly half of all physicians were aged 55 and older.
As a result, we’ve seen the growth of physician extenders. Urgent care centers are popping up in cities and towns to serve patients who don’t want to wait days or weeks for an appointment. There’s more than 9,000 of them nationwide. Pharmacy chains now offer services for routine care that previously were provided by medical doctors. Even medical tourism has grown as patients plan vacations around treatments abroad, rather than wait for openings in a surgeon’s tight schedule.
These trends will continue, since there is no cure for the doctor shortage anytime soon.
But there are other changes that will happen as health care becomes more commoditized under the Affordable Care Act.
The new health plans – just like the old plans – have benefit maximums and deductibles that run out or restart at the end of the year. What that means is that you’re better off getting a root canal in October, rather than waiting until January when you’ll have to pay more out-of-pocket because your deductible has reset for the year.
This will cause an advertising frenzy during the final few months of the year with various alternate health clinics competing for dollars. Think “Back to School”– but in October.
“Get your teeth whitened before the holidays!”
“50% off all new eye-wear before the New Year!”
“Buy one, get one free on all dialysis visits!”
Politics aside, the Affordable Care Act is creating the ability for more money to be spent on health services by more people. And where there is money, there is opportunity. I predict we’ll see more back pain clinics and sports massage centers – maybe even a greater push to legalize medical marijuana dispensaries.
No question, more people will have more access to care. I just wonder who will be paying the bill when dental spas become as common as nail salons.