For 33 years, Philip Henderson figures he has delivered 6000 Southwest Washington and Northwest Oregon babies, be they birthing a cherished first child in his practice or seeing crack babies while he’s volunteering at the local hospital on “City Call.” 

 ‘P3’  as they call him, who graduated from Longview’s Mark Morris High, is the son of a doctor, Philip Henderson, Junior; who was the son of a doctor, Philip Henderson; who was the son of a doctor J.W. Henderson. There’s been a Dr. Henderson practicing medicine continuously in Longview since the 1920’s.

But not anymore. The run up to ObamaCare and losing big HMO contracts are driving the Lower Columbia Women’s Health Clinic out of business. It officially closes June 14th. Four thousand letters have been sent to patients seen at the clinic in the last three years; the last babies will be birthed and  patients who haven’t delivered by that time will be handed off to a local HMO.  Longview-Kelso Kaiser OB patients are being sent to a Vancouver hospital some 40 miles away.

This is what Longview’s OB-GYN medical care will look like from now on. 

And that’s before ObamaCare is fully implemented.

Henderson’s experience puts the lie to the President’s proclamation that, “you’ll be able to keep your doctor.” His patients won’t. In fact, he and his partners are the very embodiment of the growing cliche about ObamaCare, “Everyone will have insurance, but not everybody will find a  doctor.” 

The regulatory burden of ObamaCare is already being felt by the ‘little guys.’  To be in compliance with Federal Regulations-and avoid a hefty penalty– over the past year and a half  Lower Columbia paid for and implemented a spanking new electronic health records system. Each partner had to scramble to come up with thousands of dollars. They swallowed hard and paid  for the ObamaCare health records software which is of no use to them now. Worse, now that they’re closing, Henderson doesn’t have much hope of recovering the Federal rebate promised physicians who followed the law.

To complicate matters, two partners have unexpectedly left since January of 2013 for personal reasons and due to what ObamaCare would do to their practice.  That left the two remaining partners left to shoulder the burden of the patients and overhead and their voluntary City Call at the local hospital. For Lower Columbia there was no waiting it out till it got better. It wasn’t going to get better. President Obama’s health plan had seen to that.  

ObamaCare is forcing a consolidation of services to hospitals and HMO’s, something that will strengthen their cash on hand position but not so with smaller clinics,  in fact things will be getting worse. Smaller clinics like Lower Columbia must also absorb the costs and burdens of extra regulation and then wait for the glacially acting government to reimburse them. Keeping the clinic open, patients served and employees paid requires cash coming in.

All that ‘free’ medical care is expensive. 

And ruinous. 

Employers will be doing what the government has incentivized them to do and dumping patients into exchanges that the Feds euphemistically now call “Medicaid Plus.”  That, along with changes in Medicaid (ObamaCare) eligibility to 400% of the poverty level, will dump another projected 100,000 to  200,000 patients on Washington State’s Medicaid/ObamaCare program. Doctors will be expected to float Uncle Sam a loan for all the extra, ‘free’ medical care and then hope he comes through with a check in a timely manner. Well, there’s a first time for everything. 

Meantime, there’s a real world cost, as Dr. Henderson explains,

“We didn’t want to close. Our patients are losing their doctors. Our employees are losing their jobs. We’re losing our jobs,” says Henderson.

The downstream effect of Lower Columbia Women’s Clinic’s closure will resonate with the local specialty and primary care groups such as radiology and pediatrician groups  and labs where 20% of their business will disappear. 

In much the same way the President’s restructuring of GM saw hundreds of car dealership owners stripped of their livelihoods,  government regulations are picking winners and losers in the health care biz. The losers? Small practitioners and their patients. Patients who came from not only Cowlitz County, Washington will lose their doctors, but patients from  Ilwaco to Astoria to Chehalis to Raymond and beyond,  who came to Lower Columbia will not “keep their doctor” as the President promised them.

Because he lied. 

Smaller clinics like Lower Columbia are the first to fall. 

Local doctors wonder aloud if Lower Columbia’s fate is the canary in the coal mine for other medical professionals in Longview. 

And what loss is there to a community when the local doc goes out of business? Personally, Henderson did what many doctors do: he gave back to his community. He opened the first ‘no doctor’ clinic to give women without doctors a place to go. He fought for the Maternity Access Act of 1989 to convince Washington State lawmakers to improve community access care to women in need of prenatal care. He volunteered his time FOR TEN YEARS to give students at both local high schools ‘the talk.’ Henderson taught about teen pregnancy and STD’s much to his kids’ consternation. As part of his commitment to the community, Henderson and his partners were the guys who took what’s known as City Call –to take all patients in labor who come into the ER and Labor and Delivery nights and weekends. Most of the work is done for free.  

One day Dr. Henderson tallied up all the free City Call care he’d given to the region since he’d been in practice: Five and a half years. As a primary care physician, he probably hasn’t SLEPT that much since he started med school.  It has to equate to hundreds of thousands of dollars of free care–on top of all the other stuff he was doing for the community. Now, with only one OB group remaining in Longview, those Docs will have to take all those City Calls. Every night. 

How long will they last?

It’s a sure bet that other clinics will be put under the same fiscal pressures under ObamaCare with the consolidation of medical care at large hospitals. It’s clear what the future holds: Doctors will now be employees of hospitals and no longer have their own private practices.  Doctors’ jobs will be just another 8-5 like in Britain and Canada. Doctors’ care will get closer to becoming commoditized. Pay will go down commensurate with what will be required of them. 

With a projected 200,000 new patients thrown into Medicaid (ObamaCare) in the coming months in Washington State (17-30 million nationally), it’s easy to do the math:

More patients / Fewer doctors = Less care

This is what ObamaCare looks like. This is what redistribution looks like. 

This is the future of medical care in the US. 

Next: My brother in law the doctor now has to find a job.