What does health care decision mean for doctors, patients?

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But the supreme court's decision to uphold the core of the president's health -- a -- yesterday could be a lifesaver for some.

But others see it as a potential problem for an already struggling medical industry.

That is because more and more people will likely join the insurance rolls.

-- primary care doctors and many other doctors are already in short supply in this country so what does it mean for you and your doctor.

Doctor Mark Siegel is a professor of medicine and why use lingo and medical center.

Doctor David somebody is chief of the division of robotics at Mount Sinai Medical Center here in New York City both we are honored to say -- members of our Fox's medical eighteen.

And host of FOX News Sunday house call to help.

So this is you know I have to tell you I I asked folks on Twitter last night how you feel about this ruling and then the feedback from so many was.

They feel scared they're scared about what this means for the people who do have insurance.

And and what it means for them in their doctors -- -- in part.

It's already hard to get in to see your doctor it's hard to get your doctor to give you a lot of time people are worried about whether the doctor can give.

The full care that he or she wants to give.

Under the new law lets start the doctor shortage doctor -- how many doctors are we short and how does the addition of some thirty million people to that.

You know insurance rolls affected.

By the -- million before I answer that I wanna say the idea of covering preexisting conditions and the idea of their being.

Health insurance universally across this country is something that everybody's happy about right but.

Who's gonna take care of you in the Association of American Medical Colleges predicts a shortage of a 160000.

Doctors in the United States by 20/20 five.

Because not only because of this law but in part because of the expansion of this -- and I'm also concerned about something I would -- doctors discontent.

Because it's not just.

Shortage of doctors it's what about the doctors -- already practicing are they gonna restrict themselves to insurance are they were -- particular procedure isn't covered.

You know are they finding that they have to restrict what they actually order for their patients -- somebody here when the top -- prop one of the top prostate certain anymore product while the -- he's one of the top plastic surgeons in the world period but he doesn't technique.

Which he actually invented called a Smart technique it's the somebody modified.

-- -- -- I guess which is unbelievable actually.

And he's the only he's invented this technique but the point is he's an artist.

So how is an independent Medicare advisory board gonna figure that out -- -- look at statistics and they're not necessarily gonna realize that one surgeon is more experienced and another he's -- what.

Thousand cases so what does that mean other -- -- -- obamacare creates this independent medical advisory board and what are they now going to be telling doctors like you -- -- Look I think it mark's point is well taken we're going to have they changed that everyone asked for -- -- here the question is how are we going to deal with us.

And the to a tier system that we spoke about yesterday is going to become a reality where the rich.

I had a pocket for the best doctors and and everybody else.

Has to choose among the second tier.

And there's no way around it you know why because thanks to his war he has -- who grew longer and longer.

Now we're seeing 78 year old big you'll come into the office basketball Viagra that has never happened many care -- we did exactly what.

-- many parents supposed to be you pay a lot of money.

And then after six to five maybe you -- few years and then you're done now with Plavix aspirin cardiac stent.

These guys are living longer and longer which is a great thing.

And today every day 101000 people turned 65 and there are Medicare eligible so how we're going to take care of this mass volume and what's gonna happen is.

Some of us among doctors have to decide are we going to accept his -- -- we're going to see big volume.

High quantity but maybe cut down -- so the quality.

If you -- in the waiting for about an hour half -- -- your doctor for ten minutes don't be upset that's access to care that you're gonna get on the other hand.

Maybe somebody else will say you know what I want to have you for the whole hour and a willing to pay for -- let's listen to me and take care of me that's the way there's an idea.

I would add to that by the way -- everything.

-- partitions always send me emails when we start talking about this and they say he talked about the -- Assurant wanna you mentioned that nurse practitioners are up by 80% over the past decade.

Fair enough.

And many of them are very well trained and quite capable have a very important role in medical situation but.

They're not only do they do not have the same training as me in darkness of money and I think that they are extremely useful but they can't just replace that you can't.

You can't.

Take us out and put them -- -- something to and I want to say that there's rule of nurse practitioners and medical assistant.

Should not be to replace us because he's gone through four years of medical school years of residency training so by the -- -- I have to tell you.

We have shortage of anesthesiologists.

So we have nurse anesthetist -- work really well they can call her multiple rooms.

And anesthesiologist can cover them immoral practice superb medical assistance nurses -- that actually need more with me so I think there are big.

Component of what we do every day and we got -- office can survive and it's.

-- can't replace what is your that he but that he doesn't let me ask you this because it sounds like we had a doctor shortage before obamacare.

And -- Monica did nothing to solve the doctor shortage -- and -- there are some incentives for you going to primary care practice now but it's not there's -- -- and okay so they didn't it didn't solve the doctor shortage and yet it added millions to the insurance rolls.

So that bit but but I think -- so that's one piece of this or we're gonna be understaffed and the doctor front.

But you're taught that the business that you're talking about about more regulations and restrictions on how you practice.

Is what a lot of folks worry about as well like is somebody now telling you what what tests you can and cannot order.

If however you want your regular believe there are I have got hurt us a patient with prostate cancer and it was a -- risk prostate cancer on the surface so I asked for a study of bone scan to find that the cancer.

-- spread or not.

We quality assurance company -- that -- miss -- it's the united wide because they have a list of stuff.

As almost typed in front of them and they -- response -- cancer.

Don't improve bone -- But what they don't know is that this particular patient on the surface has -- prosecutors have but that it's higher prostate.

-- packed with prostate cancer he needs -- bone -- so for me to get on the phone which takes another hour of my time.

Try to make you understand how the Obama there create that situation is already the problem was there and that's going to be more magnified because now you -- inherited.

Another thirty million people overnight -- a numbers game.

-- -- getting 33 more committees.

You getting committees that are gonna say when treatment is better than another insurance company's US preventive service task force -- obesity let's look into that.

No PSA.

The and I know mammograms forty to fifty it would all of these things insurance companies picked them up.

And they -- deny deny deny what I wanna I wanna city who has an attorney -- really important piece that you may not realize if I wanna test.

And I try to order and it -- and -- And we end -- missing something.

The insurance companies not -- the government is not libel the -- remains liable that you are unreliable because of that that puts more and more and more pressure on mark.

But -- -- to truth is that the debate between.

Health care being a privilege vs right.

I'm having full access and having preexisting all of those are healthy debate so that all the doctors in the country they all wanted this is a must want real question is how are we going to take care for -- Not this stuff that's been discussed it obamacare or what we're talking about is really going to solve the problem you know why.

Patient's responsibility is the way to -- they always say well you know -- Europe they're spending less money.

But to have a better outcome but you know what we're not Europeans we don't need the same food we don't think the same were threatening obesity in this -- -- about third of the country suffering from obesity.

Diabetes is on the rise I can give you any kind of interest you want but if you're not gonna end -- Yourself pursue a healthy living it's not in terms -- patient offensively.

Agree with this -- also you know United States -- pay only 12% out of pocket for medical expenses that's among the lowest in the world.

If we actually would pay more we -- know more or getting it since we didn't go through this we -- some -- here guys what a pleasure.

Brilliant actors on assess what is until they're married well what sunny hot tempered in -- -- well right here on Edmonds added thank you arrived here.

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What does health care decision mean for doctors, patients?

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