Dr. Singleton: Obamacare May Create Two-Tiered Health System

Wednesday, 05 Dec 2012 03:39 PM

By Dan Weil and John Bachman

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The Affordable Care Act could leave us with one (strong) healthcare system for the rich and another (weak) one for the poor, says Dr. Marilyn Singleton an anesthesiologist who is an expert on Obamacare.

“Some family practice folks say that we’re down about 50,000 doctors,” Singleton tells John Bachman of Newsmax TV. Under Obamacare, “nurses and physicians assistants are slated to take up the slack, the so-called physician extenders,” she says.

Watch the exclusive interview here.



“This starts to smell of the two-tiered system, where if you have regular insurance if you can afford it, you can see a doctor. And then the lower paying insurance people will be seeing nurses or physicians assistants. There’s no question that they do have some skills, but most people want to see a doctor.”

Singleton also is worried about the 27 percent reduction of reimbursements to Medicare physicians that will occur if we jump off the fiscal cliff. Such a cut would amount to more than the operating expenses of many practices that treat Medicare patients, she says.

“Unless you have a large practice that balances out the patient population with young, healthy people on regular insurance, you just can’t afford to treat these folks, and it’s just not fair. Many doctors are opting out of Medicare, and we just can’t have that happen.”

While the Congressional Budget Office estimates Obamacare will cost about $1.4 trillion over 10 years, the real cost is unknown, Singleton says.

“We have to hope it doesn’t go the way of the Medicare projections that were off at least fivefold. Can you imagine if this is off fivefold?” she says. “And where is the money supposed to come from? Payments to hospitals will go down, and already people are talking about cancelling contracts with Medicaid service.”

The poor will end up in “charity-type hospitals, and the people who can afford it will be going to the nicer hospitals,” Singleton says.


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