My wife and I have a great doctor. She has a small clinic nearby with a few other doctors, who are also all very good. Our doctor has a waiting list for people who want to be her patient. We have over the years recommended several people, even some who live 20 miles away, to her. She is very nagging–in a good way. She makes you promise to get a physical, eye exam, etc., intervenes to get you an appointment with a specialist if you need one, etc. Follows up by phone, and so on. She is great.

She recently announced to us that she is moving to some kind of “concierge” service–she figures she basically provides that kind of above-average service already, and this is a way to reduce her patient load (from about 4000 to about 400), and escape some of the regulatory burden that Obamacare is going to impose. So she’s picking a select group of her current patients–about 10% of them–and they will be allowed to remain her patients–for $1600/year each. Now, we love our doctor, so will probably do this. And 3600 of her patients will now lose their favorite doctor. Thanks, in part, to Obamacare.

So, you can see what’s coming. The affluent will have to pay more–in our case, $3200 a year more–but for even better service than we already get. And others will have increasingly slim pickings. Case in point, I mentioned this to some friends, and my TLS co-blogger Brian Martinez noted: “This is what my wife’s doc did, too. Went to a concierge system. Unfortunately we couldn’t justify the extra expense and pay for health insurance for the rest of the family. So my wife had to leave her doctor of 10 years and find a new one, and she hates to switch doctors.”

Expect to see more of this. I had never heard of it before and am still waiting to hear the details from our doctor (some information will be mailed later), but a google search revealed that this is indeed a growing trend; see Health care reform laws prompt surge in ‘concierge medicine’, Are Concierge Medical Services on the Upswing?, and Royal Pains: Can Concierge Medicine Coexist With Obama’s Healthcare Plan?

So, Obamacare will only exacerbate healthcare “inequalities,” and diminish the quality of care of many people. The government will then use this as an excuse to bash “greed” and “inequality,” and clamp down further, driving us closer to outright socialized medicine. As one of the articles above noted, “Critics say boutique medicine will only exaggerate the health insurance crisis. Many doctors may leave traditional family practices — widening the gap between the affluent and the poor.” As Martinez noted to me, “You know all the good doctors with wealthy patients will follow this route and as you say it will prompt the regime to crack down on this ‘greedy’ practice. [expletive deleted] Obama.”