American doctors are increasingly turning to concierge medicine, where a patient pays a primary-care physician an up-front retainer and in some cases additional fees in exchange for special attention and enhanced care.
The American Academy of Private Physicians estimates that there are now some 4,400 concierge physicians, up 30 percent from last year.
And a recent survey cited by The Wall Street Journal disclosed that about 7 percent to 10 percent of physicians plan to transition to cash-only practices in the next one to three years.
"With doctors already spending 22 percent of their time on nonclinical paperwork, they will find more government intrusion under Obamacare regulations taking even more time away from patient care," according to the Journal article by Dr. Scott W. Atlas, a physician and a senior fellow at Stanford University's Hoover Institution.
More Americans are likely to opt for concierge medicine as they experience more difficulty finding a doctor willing to treat them. The Association of American Medical Colleges estimates that the nation faces a shortage of more than 91,000 physicians by 2020.
Already, about one-third of primary-care physicians and a fourth of specialists have completely closed their practices to Medicaid patients, and more than half of physicians have limited Medicare patients' access to their practices, or are planning to.
Many of these doctors refuse patients due to inadequate payments from Medicaid and Medicare.
"At the same time," Dr. Atlas noted, "Obamacare is squeezing out the middle class from affordable private insurance that correlates with far better disease outcomes than government insurance.
"Unless Obamacare is drastically altered, America's healthcare will become even more divided, with rising inequality. Only the lower and middle classes in America will suffer the full consequences of Obamacare."
Scott W. Atlas: The Coming Two-Tier Health System - WSJ