For more than 20 years, David Scheiner was Barack Obama’s doctor. The relationship lasted until Obama got a new job in Washington, DC, and could no longer visit Scheiner in his cramped little office in Hyde Park.

But during those years they spent quality time talking about health-care policy, and Scheiner made it clear to his patient that the only way to fix the American health-care mess was with a robust, government-centered, single-payer system. Obama may or may not have agreed, but that wasn’t the policy he pursued when Obamacare began to take shape.

Dr. Scheiner hasn’t hidden his disappointment. Even if Obamacare is fully implemented, it will still leave more than 20 million Americans without any form of health care, he says, and that’s a disgrace for the world’s largest economy. He’s certain that the Affordable Care Act simply doesn’t go far enough.

We invited Dr. Scheiner to be our sole guest on this week’s show to start 2013 with a discussion about where America’s health-care system is today, and where it might end up by year’s end.

Scheiner has plenty to say about the current state of the medical industry itself. Creeping corporatism, he says, is wiping out private practice. And just as the coming expansion of the health-care system will require vastly increased levels of primary care, the number of primary-care physicians is dropping, he says. Long hours, high stress and relatively low pay make the field unattractive to young practitioners, he claims. Instead, they prefer the more relaxed lifestyle of the sub-specialties.

Scheiner also laments the introduction of “hospitalists”, doctors who work exclusively in hospitals, managing dozens of patients simultaneously while excluding the patients’ own  physicians. It’s all part of the continual pressure to move patients out of hospitals more quickly, and that involves many more expensive and, Scheiner says, inconclusive or even deceptive, tests.

It’s an interesting view of American health-care from a man who’s been a vital part of it for five decades, and is still  very active, and very opinionated, today.