A perplexing problem with the recently enacted health care legislation has arisen even before it becomes fully in place in 2014. And this has profound implications for the future of health care and for each of us.

Recent news stories have pointed out that physicians across the country are limiting Medicare patients. Some refuse to accept new patients. Some limit the number of current patients they retain after they enroll in Medicare. Others use both approaches.

Surveys among physicians indicate that from 15 percent to 30 percent have been forced to limit patients. The percentage varies by medical specialty.

The top two reasons physicians give for limiting Medicare patients is the ongoing threat of future payment cuts and the fact that payment rates are already too low.

This does not bode well for the future of health care reform since the first of the baby boomers — those born between 1946 and 1964 — will start enrolling in Medicare in less than four months.

The problem will be further exacerbated with their entry onto the Medicare rolls.

The scenario that is unfolding illustrates several principles that lawmakers overlooked when framing the massive overhaul of the system earlier this year. Perhaps the most important is the basic economic principle of supply and demand.

In passing the health care reform legislation, Congress increased the demand for physicians by adding 30 million peoplee — many of whom will be on Medicare or its cousin, Medicaid — over the next several years. They did this without taking action to increase the supply of physicians or to adequately fund the cost of Medicare.

At the time health care reform was enacted, there was already a shortage of primary care physicians.

What does this mean for the future? One fact seems virtually certain. Despite the rhetoric when the legislation was passed, the cost of health care will increase.

And taxpayers will foot the bill.

Wayne Curtis is on the board of directors of First United Security Bank. He can be reached by e-mail at wc_curtis@yahoo.com.