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New questions about impact of health care law on Americans

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    How does the mandate affect the care you receive?

  • Duration 8:04
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If you like your doctor.

You'll be able to keep your doctor period if you like your health care plan.

You'll be able to keep your health care plan.

Interior.

No one.

We'll take it away.

No matter what.

When I was President Obama a few years back pitching his health care -- to the American people.

Before it was even past opponents to the plan predicted the law would result in a two tiered medical system.

Saying it would continue a trend that had -- started in this country.

Of most Americans getting factory medicine complete with the rationing of care.

While the elite would pay cash for top notched individualized care.

My next guests say that's already happening.

Doctor Mark Siegel is a member of our Fox News medical eighteen.

And doctor Elizabeth Eaton is an OB GY and and clinical assistant professor of obstetrics and gynecology at NYU school of medicine.

And did.

The most brilliant OBG weigh in on earth.

And the woman who delivered my two children so thank you so -- for being here.

I am one of the elite apparently because I -- paid doctor Eden.

Out of pocket but -- I submit for reimbursement from my insurance company and you are one of the doctors who is gone too.

Cash payments you don't take insurance any more directly -- take Medicare aim anymore.

Why did you do that.

I did that because I was seen so many patients in a day when I belong to the managed care.

Networks.

That I couldn't.

Spend enough time with each patient.

Where I felt that I was comfortably giving them kind of medicine that they deserved.

And you feel that now people like you -- difficult position because now you have less volume.

Right that's that enables you to give more time to people like happy -- we actually became friends because you spent so much time with me and -- now -- my -- she's my friend now.

But what is -- about their doctors -- -- -- they take -- you win and now it's like a factory in most places.

But the reason you can do that is because you have fewer patients if you have more patience you make more money.

But you say you've got too -- not practice now.

You may or may not make more money the problem is you can't give the kind of care that you want to get that many patients there isn't enough time in the day to bring can't.

Go back -- it's just it's not good medicine let's take care of the large volumes of patients.

So.

If you want to practice medicine the way we all really.

Went into medicine for almost arrested.

You have to -- a reasonable number of patients and the reason.

The managed -- the managed care companies reimburse at such a low rates.

And that's why you have to see so many patients in order to pay your overhead and as -- sent malpractice insurance is huge part of that over.

Right especially for a would you -- who gets it all the time not you because you're brilliant.

But that a lot of OBG -- -- single they have these enormous not practice costs and so third place in this untenable position doctor Siegel.

The the problem is most people cannot afford to pay out of pocket and -- submit for reimbursement go through all these hoops.

And so they're going to be put into the factory system where you get three minutes with your doctor if you're lucky you get the face -- with the doctor.

More often than not they -- you offer some testing you're never seen them.

-- you have to -- -- -- this was already happening.

Before Obama -- and you've just described it but it's his -- getting worse now under Obama care.

You co pays are going down the deductibles are going down so there is no disincentive for -- because you're not paying out of pocket you're the insurance will cover you.

The worst problem is it covers the worried well so my office is filled with people who -- sick.

So insurance will encourage you to use the product insurance before you're actually sick if you're sick.

They may not want to see the big -- Shooting get out of -- -- they predict that -- well people would be spending time the doctor getting preventative medicine you're you're sick people be there because there's a disincentive for the insurance companies to have -- -- -- -- -- -- Right but at the same time the cutting down with doctors can.

Can charge our fees are going down.

And more and more paperwork and more and more committees are coming it.

And -- the independent Medicare advisory board is gonna set the standards what you calling rationing in the other private insurers are gonna follow suit.

So my office gets more and more filled than I do take most insurance is.

With people that I would be forced to see in shorter and shorter periods of time that I wanna send to a super specialist.

Doctoring is not available to -- expects with her training to deliver a baby and all that goes into it and get paid less and less and less I should be crazy to do that -- the lake Olympic.

So -- -- a shrinking that work.

Lets people available of top notch people to use and patience that I got to see more and more and more paid be paid less and less.

When describing a perfect storm for two tiered system of health care where people can afford it.

Like you or like me go to doctors that we pay out of pocket for concierge medicine boutique medicine people that have the time to take care of right.

And the problem is -- you who you talk to me about this where if you go to factory medicine that forgive the term because of that you understand sharper.

You go to doctor who's in this factory type practice.

They follow certain guidelines that are being handed down.

And in the field -- -- you and to take -- there there are some that are very questionable that you have election to say I.

I'm not following -- tell us.

Absolutely true and they may not be forced to follow those guidelines but they are encouraged to follow -- headlines and for example.

There's recently been a change in -- guidelines for pap smear screening intervals between which.

Wearing women should have pap smears and when they should start to have pap smears and above a certain age they shouldn't have them anymore and this is not the way -- practice medicine this is not.

This is not a good way to practice medicine we're gonna -- disease.

For -- we're going to increase the incidence of cervical cancer if we don't screen for -- like we've been screening.

For the last sixty years in the past there was invented I have with the eighty year old patient who came in for you and wanted that -- -- something that I get -- annually you know any you know much more.

If it -- threat cervical cancer but she wanted one.

Yes it's a recent -- in recent story -- storied eighty year old woman came into my office new patient.

-- an incredibly useful woman.

And then moving well looking well just incredibly life full.

And she was new to me so she said she's been seen by her former gynecologist for a long long time and that he had the audacity to -- she said.

And then.

She then saw a female beats you I managed -- -- never going back so I said you know okay.

And then we started to talk and -- have are you gonna do Pat Smear to and I said.

Of course.

And she said well that's that's good that's great because -- a friend and 78.

And her doctor wouldn't do -- pap smear and she was just diagnosed with cervical cancer.

And this female a BTU AM that I just saw that I never gonna see again refused to do perhaps for me because I'm maybe.

So I mean what's the bottom line and it's this the future of medicine.

I -- to use this term but I consider a cancer on the health care system I'll tell you why less than 50% of physicians are taking new Medicaid patients or expanding Medicaid by sixteen million more people.

Doctors are gonna refuse to -- no more -- some of the some specialties like -- or psychiatry can't find the psychiatrist -- -- with insurance at all.

None of this was considered surgeons let's say well the hospital takes this insurance but we can't take it to you might -- The President Obama it was meant to expand access for people is supposed to provide -- -- doctoring for people who couldn't afford it didn't have -- I election why it's such a -- when he says you get to keep your doctor patient doctors move into a hospital -- -- hospitals -- university.

Medical centers may be able to survive -- -- -- look at the bigger bottom line but then everybody becomes salaried employees.

And again the quality of care goes down it's going to be like -- street and in London.

I think that the people that can really afford it will go to the private boutique doctors everyone else is gonna be a system where they don't get what they want.

-- if they can see me whenever they wanna see me I think they'll be able to see them.

That's right and that's a difficult that situation wasn't too brilliant great awesome doctors both of whom I highly recommend if doctor -- doctor Siegel thank you both there and.

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