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If historical precedent is anything to go by, the Tea Party will be going round saying "I told you so" and trumpeting an "Obamacare failure" by February. They will point to the inability of patients to book routine tests mandated under the scheme (mammograms etc) as evidence that this "socialized" healthcare system has led to their predicted "death panel waiting lists" or some such nonsense. But this will be evidence of success, not failure.

Look back to Britain in 1948. In July that year the comprehensive National Health Service, free at the point of delivery, started. Prior there had been a mixture of lower paid workers (but not their families) insured by the LLoyd George 1911 National Insurance scheme; those who could afford private insurance and those who would have to pay out of pocket. (In a similar way US patients are now split between medicare/medicaid/VA; the insured and the uninsured).

The pent up demand for health services can be judged from this comment from the receptionist at a GP's surgery (these primary care physicians act as a first point of contact and "gatekeeper" to specialist services):

Mary Dowlding joined the Warders Medical Surgery in Tonbridge, Kent, as a receptionist on the day the NHS was launched.

"I arrived in the morning and the queue was from the door, down the street and disappeared into the High Street," she said.

"I think they came because they wondered what was happening and they wanted to see if they were going to have free medicine. It was such a relief, particularly to women with young children who could not afford to call the doctor out."

Now there are significant differences between July 1948 in the UK and January 2014 in the USA. In the UK the pool of uninsured and its proportion of the population was much higher than the number of newly covered in the USA in the New Year.  On the other hand the UK still had food rationing in 1948 which perversely improved the overall health of the nation. Today there are far more routine tests which will be available for newly covered Americans and, dare I say, a likelihood of much underlying illnesses associated with poor lifestyles.

The essential aim of "Obamacare" is not to extend insurance coverage; it is to ensure those previously unable will be able to access health care including routine diagnostic tests. Its success will be measured in those who are now able to get long term problems treated and those whose lives may well be saved by a routine test for cancer or diabetes. In short, how many Americans get treatments and tests that have previously been unaffordable for them.

So come January it is reasonable to expect there to be a surge in demand for appointments for these tests and to see a primary care physician or specialist. Those previous patients expecting to be able to book an annual or two yearly test will find the clinic is booked solid for weeks ahead with the newly covered. Reports will filter back to the GOP who will claim this shows Obamacare has broken the US health system.

Prepare for this in two ways. On the personal front, make sure you book your routine tests due in 2014 ASAP. On the political front, expect this surge in demand. Proclaim it as the success for the ACA it will be.

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Comment Preferences

  •  Tip Jar (14+ / 0-)

    We will work, we will play, we will laugh, we will live. We will not waste one moment, nor sacrifice one bit of our freedom, because of fear.

    by Lib Dem FoP on Wed Nov 20, 2013 at 07:40:50 AM PST

  •  I suspect that any such difficulties (3+ / 0-)

    will depend upon where one attempts to book.  Rural areas, which have the most limited facilities, will probably be hit hardest.   Urban areas, which tend to have a greater number of facilities, but also a greater number of potential patients, will probably be impacted as well.  I suspect that suburban areas will be the least impacted, as there tends to be a fairly large number of facilities available, and a greater proportion of the inhabitants already had health insurance.

    And, there will be regional variations.

    With the Decision Points Theater, the George W. Bush Presidential Library becomes the very first Presidential Library to feature a Fiction Section.

    by Its the Supreme Court Stupid on Wed Nov 20, 2013 at 08:00:46 AM PST

  •  In NYC a mammo can be had tomorrow so I (0+ / 0-)

    don't think we will have a big issue here

    "The poor can never be made to suffer enough." Jimmy Breslin

    by merrywidow on Wed Nov 20, 2013 at 08:12:30 AM PST

    •  ... (0+ / 0-)

      Surely you are a decent person, and surely you did not intend your comment to be read this way...

      But do you understand how callous this comment sounds?

      A lot of us don't live in NYC, or the outer boroughs, or even in Yonkers.

      As the diarist suggests, just as every case of leukemia in San Mateo will be blamed on the Dtap vaccine we can expect the Goopers to blame every delayed appointment and every case of the shingles on OBAMACARE SOCIALIZED MEDICINE DEATH PANELS!!!!!

      And we need to be ready for it.

      The moment you pick up the clay you become a demiurge, and he who embarks on the creation of worlds is already tainted with corruption and evil. (-8.7,-9.3)

      by Dom Segundo on Wed Nov 20, 2013 at 10:07:05 AM PST

      [ Parent ]

      •  I was only mentioning that these issues (0+ / 0-)

        will be rural rather than urban mostly and were the same before ACA

        "The poor can never be made to suffer enough." Jimmy Breslin

        by merrywidow on Wed Nov 20, 2013 at 10:32:33 AM PST

        [ Parent ]

        •  Buenissimo (0+ / 0-)

          Certainly these  issues predate ACA by many decades, but it's not a rural/urban divide.

          One of my hobbyhorses is that candidate Obama in his alleged "clinging to guns and Bibles" speech was in fact appealing to those left behind by the so-called New Economy and had to make their way in the wreckage left behind.

          The moment you pick up the clay you become a demiurge, and he who embarks on the creation of worlds is already tainted with corruption and evil. (-8.7,-9.3)

          by Dom Segundo on Wed Nov 20, 2013 at 10:55:27 AM PST

          [ Parent ]

        •  What has changed: (1+ / 0-)
          Recommended by:
          Dom Segundo

          pre-ACA, folks didn't "demand" as many services because they couldn't pay for them. Now they will be able to get in the queue -- so the availability/supply issues will actually get worse, because fewer people are left outside the gate.

          Since the newly-empowered customers are coming with an insurance card that will pay, I expect the health care providers to be able to rise to the occasion by increasing hours, facilities, etc. etc.

          •  +1 (0+ / 0-)

            As  a total aside (even to the point of threadjacking?) I support blood donations thorough the  playing of rugby.

            Some ear gets chawed off in the darkest pits of the scrum? Welsh noob oughta used protection.

            Just like Bob Dole's criticism of Gerald Ford: too bad he didm't wear a helmet.

            The moment you pick up the clay you become a demiurge, and he who embarks on the creation of worlds is already tainted with corruption and evil. (-8.7,-9.3)

            by Dom Segundo on Wed Nov 20, 2013 at 06:46:06 PM PST

            [ Parent ]

  •  As someone once noted here, re: medical care, even (4+ / 0-)

    When it is free, a lot of people will only get what they really need.

    Few people are gonna say "Ooh! A free colonoscopy! Sign me up!" Just because it's free.

    We don't want our country back, we want our country FORWARD. --Eclectablog

    by Samer on Wed Nov 20, 2013 at 08:22:24 AM PST

  •  Exactly (0+ / 0-)

    When I relocated home from South America to one of the twenty five largest metropolitan areas in the country, it took forever to get myself integrated into the local health care system.

    For fork's sake, the first time I spoke with my scheduled primary care physician was in the emergency ward after I had a gourd dimned heart attack.

    The Goopers are going to presume that nobody in America knows any better and that their lies will be believable.

    And they will be right.

    So we need to be proactive and get the word out.

    The moment you pick up the clay you become a demiurge, and he who embarks on the creation of worlds is already tainted with corruption and evil. (-8.7,-9.3)

    by Dom Segundo on Wed Nov 20, 2013 at 09:55:19 AM PST

  •  We've always had this with Medicare (0+ / 0-)

    One of the arguments for the ACA is that many people without insurance put off medical care and even screenings until they reach 65 -- I've forgotten the stats, but people age 65 have unusually high Medicare utilization rates, and then it tapers down.

    In theory, one would expect the ACA to reduce the pent-up demand that currently impacts Medicare budgetting. I don't know if the Congressional Budget Office has included that in their number-crunching, but they should.

    This will not show up in 2014 Medicare numbers, but should begin showing up in 2015 and beyond.

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