There may be a debate over whether Obamacare’s individual mandate is a penalty or a tax, but there is no debate among doctors and their patients about the fact that Obamacare will be bad for America’s health.

The climate in my medical office is changing; my patients sense that a storm is coming. They are worried, and there is little I can do to reassure them. They are used to my office manager getting approvals for the CT scans, mammograms, PSAs, and MRIs I order, and they realize that many of these tests will no longer be covered by insurance once Obamacare’s committees — which look at so-called comparative-effectiveness research and review current guidelines — are through with them.

Last week, with the Fourth of July looming, I was able to get a quick CT scan to rule out appendicitis for one patient, and an ultrasound of the legs to quickly diagnose a blood clot for another. Tests like these — ordered solely on the basis of my medical intuition – may not be possible in a few years. Since in both cases the symptoms weren’t “textbook,” I would probably have had to appeal to some Kafkaesque committee, wasting precious time; in an extreme instance, this could even cost a patient his or her life.

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