 The Patient Protection and Affordable Care Act (ACA), more infamously known as Obamacare, is once again in the news due to a lack of foresight in developing and writing this law. The problem is a lack of qualified physicians to treat the newly insured and the millions more to follow. Somehow, the architects of Obamacare failed to properly address this critical topic when formulating HR 3962. A December 7 AP article described the healthcare plight of 61-year-old Olivia Papa as she has struggled to be seen by a primary care physician after signing up for insurance through the ACA exchange. Though relatively healthy, she and her husband needed to see separate specialists, so she called the doctor assigned to her, only to find out that the doctor wasn't on the plan. A new doctor was assigned, but the result was the same; she left a message to make an appointment, 'and they never called back.' Physician shortage identified years ago made far worse by Obamacare The shortage of physicians was identified as an impending issue by numerous healthcare organizations some years ago based on pre-Obamacare physician and population trends. Several studies noted that there would be shortages in primary care physicians as well as in the fields of geriatrics, pediatrics and general surgery. Instead of addressing the problem with a coherent plan, Obamacare created a policy that amounts to putting a band-aid on a compound fracture. The issue was identified in a 2012 report [PDF] by the Association of American Medical Colleges (AAMC). The report clearly identifies the legislative issues that Obamacare failed to address, including physician training: Physician training is inextricable from patient care and Medicare has historically paid for its share of the costs of training and the highly sophisticated health services provided by teaching hospitals. The Balanced Budget Act of 1997 capped Medicare-funded GME at 1996 levels for almost all teaching hospitals and continues to limit teaching hospital efforts to expand or create new programs. The ACA did not eliminate the cap but allowed for the training of approximately 300 additional physicians a year--far fewer than the 10,000 additional physicians the nation would need to train annually to address the entire physician shortage. An estimated 6.7 million people signed up for health insurance through the ACA exchange for 2014. Estimates vary, but a total of 26 to 32 million people are projected to enroll through the exchange in the coming years. Projected physician shortages are potential healthcare disaster for baby boomers The projected shortage of physicians through 2020 is 91,500, with 45,400 of those being primary care physicians, and 46,100 subspecialists, according to the AAMC. Another factor apparently not considered by the Obamacare architects: Starting in 2011, 8,000 Americans are turning 65 each day, and this will continue through 2029, says the American Association for Retired Persons (AARP) . The lack of primary care physicians and geriatric subspecialists is a potential healthcare disaster for the baby boomer generation. Anthony Halby, an insurance agent in a rural area near Sacramento, California, explained the choices that his clients face is one of cost versus coverage, according to the AP article. Several of his clients told him that they want to switch their plan when the second open-enrollment period started October 15, because the plan they had initially selected made it difficult to find primary care doctors. Two insurance companies serving the area offer coverage through the state exchange, but only five of 135 primary care physicians in the area are available through one of the insurers. The other insurer has more doctors, but most of them are considered to be out of the network, so his clients will have to pay 60 percent of the bill if they see them. Halby has recommended to his clients that they choose insurance outside the exchange. They will have to pay more, since the plan isn't government-subsidized, but they will get to keep their primary care physician. Quoted in the AP article, Halby said, 'Coverage does not equal access.' That must have been what Nancy Pelosi meant when she said that HR 3962 would have to pass so we would know what's in it. Sources: 1. http://news.yahoo.com 2. http://www.healthleadersmedia.com 3. http://www.healthleadersmedia.com 4. https://www.aamc.org [PDF] 5. https://www.aamc.org [PDF] 6. http://acasignups.net 7. http://www.aarp.org 