Free Markets, Free People

Health Care Reform Will Cause Physician Shortages

My latest Examiner column about the usual – the law of unintended consequences.


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15 Responses to Health Care Reform Will Cause Physician Shortages

  • “Among the reasons for that is low Medicare and Medicaid compensation. However, given the goal of cutting costs talked about above, it is unlikely that situation will improve. In fact it is projected that under the government health care plan now being considered, doctor’s incomes will probably decline by 15 to 20%. For the 60% that are self-employed, that is a significant cut in pay that will mean fewer jobs for those they employ. And it may force decisions about staying in medicine or going into another field for those doctors with marginal practices.

    Such results, although unintended, will create a growing shortage of physicians and that, with the increased access universal insurance will bring will lead to rationing of care.”

    Well, universal health care was already going to cause a rationing of care, since giving everyone access to the same medical services would increase demand, artificially.  However, what you say is just how the problem will be compounded, since on top of the artificially increased demand there will be a real reduction in supply.  Nice.

  • People have remarked how it will be necessary to travel to other countries for medical care.  In my smallish area (metro pop:  225,000) in Washington I am amazed when I stroll the halls of one of the hospitals and look at the photos hung of assigned medical staff.  Many are Chinese, Indian, and Middle Eastern.  These are the people that will accept a lower wage and government paperwork.  It will not be necessary to travel to foreign countries for medical care as the need for medical personnel will be filled through the immigration process with a group more amenable to government control.  What this portends for the quality of medical care I don’t know.

    • you miss the reason it will be necessary to travel abroad. It is because health care will be rationed and if you want an important operation in enough time to actually do you any good you will have to go to off shore (Thailand probably), This is compounded by the problem that there are fewer and fewer places to go that don’t have socialized medicine.

    • It doesn’t matter how far down the wage scale you are willing to go. You bottom out at “I must be able to pay my employees, my student loans, and my malpractice insurance.” That’s already enough to cause trouble.

  • Socialized medicine is not about increasing supply, it’s about redistribution.   The statist does not care if there is less health care, in fact, if people who can actually afford it get less, he is satisfied because it’s about “equality.”

  • We need some sort of skit, comedic or otherwise, to dramatize what will happen when this “health care” boondoggle is forced down our throats. Let us make it a skit between a citizen, who is about to be fugged by the gubmint under the “Savings for Health Insurance Transition” (S.H.I.T.)


    Citizen: Hello, I am a citizen.

    Government Worker (dressed in a bloody lab coat): Under the National Health Care Plan, we deem it necessary for you to go to a doctor right now. Here is your appointment with the doctor of our choosing.

    Citizen: But, wait a second. I feel fine. I don’t want to go to a doctor right now.

    Government Worker: Tough sh!t, fella. Go to this appointment, or you will be fined $1,000 under Section 10985.3.5, subsection [Q], which states, and I quote, “If you do not go to the doctor’s appointment set up for you under the Care Response Appointment Plan (CRAP), you will be fined for the first violation a sum of $1,000. If you do not respond to the second appointment, you will be fined $2,000. A third violation will mean 1-3 years in prison.” And when I say prison, I mean hard time.

    Citizen (holding head): This is shocking! I didn’t vote for this when I cast my ballot for this President in 2008! I have to go to a doctor when you want me to, or I will face fines or prison?

    Government Worker: You bet you’re a$$, fella. Now do it, or I will be back to your home with several health care workers from the institution and you will be locked up.

    Citizen: Holy sh!t!

    Government Worker: And don’t curse. Under the Plan, cursing causes increased stress for you and those around you, and is against the law. So stop doing it, or I will have you’re a$$ hauled off to jail.

    Citizen: Wait a doggone second. You just said the word “a$$.”

    Government Worker: There, you did it again. We are allowed to say these things. When I said “a$$,” I meant a human a$$. Not an a$$hole.

    Citizen: You did it again!

    Government Worker: I am entitled. Under Section 22.75, subsection [A], section R, which is also called the “Hillary Clinton Free Speech mandate,” government workers dealing with this part of the program are entitled to use, quote, “colorful language.” You are not.

    Citizen: But that’s against the Constitution! This whole rotten program is against the Constitution!

    Government Worker: That is enough. You are hereby warned that if you criticize the Plan, criticize the President, or make any comments that could cause undue stress to anyone involved with the Plan, you will be found guilty of this offense and ordered to serve 1 year in prison. Now go, darn it. You have made me upset, and I won’t be able to have my genetically-engineered lunch or my Solar Pill for dinner.

  • Law of unintended consequences?  Rationing?  Less doctors?  Less quality?  Surely you jest!  Obama promised me he would stop the oceans from rising.  Healthcare should be a piece of cake compared to that!  Now, as soon as he gets me my unicorn…….

    “Socialism is a philosophy of failure, the creed of ignorance, and the gospel of envy, its inherent virtue is the equal sharing of misery.”
    Winston Churchill

  • I think the best place to look is Germany, a country whose health care system is probably most like where Obama wants to go (and may in fact be more statist than Obama’s).  They have problems, but overall they do insure everyone and people, including physicians are generally satisfied.   The Swiss have a unique approach, having the various Cantons develop their plans.  It’s a bit more expensive than other European systems, but still does generally well.   Physician shortages are most likely to be in rural areas, but with unemployment high, medicine is still a lucrative career choice for students.   But given the problems in the health care industry and with the poor and un/under-insured it’s not like the current system works at all — it’s broken and in fact looked down upon by much of the civilized world (only the Brits have it worse in the industrialized West — and that’s because they have a really inefficient system).  If you’re wealthy in the US you have it made.  Unfortunately, for many wealthy that’s all that matters — they believe they’ve ‘earned’ better health care than others.    But now that the crisis is expanding, I think that view will be defeated (and it’s good Obama is reaching out to the people who killed Clinton’s plan and is trying to get them on board — he’s far more effective than Clinton, though to be sure he’s in an era more friendly to his policy preferences).

    • Here is my basic disagreement with ANY government run health-care program.  Health-care is NOT a right.   The government has no business whatsoever being involved, in any way,  with my health-care.  So, it doesn’t matter how good or bad any other country’s plan is.  It is irrelevant.

    • Erb,

      Our system has its faults, but it is hardly broken. And it is probably the best system in the world, overall.

      While universal coverage may be your holy grail, it ain’t mine. The best solution to our system would be to revise the tax code so that employer provided insurance goes away, and to seriously revise done (or eliminate) medicare and medicaid. Tort reform should be enacted as well.

      The key problem with our current system is that consumers don’t pay for the service directly, hence there is no market control of prices. And the insurance companies and government, which actually pays the bills, attempt to control prices through methods that drive inefficiencies like managed care.

      Obama isn’t trying to improve the system. He’s just consolidating power.

    • Germany has one of the most expensive systems in the world, it’s also facing the same problem as US entitlements and is in imminent danger of collapse.  Also, their model would be unconstitutional to implement in the US.  That is why Obamacare is really just evolving into an expansion of Medicare, but with the added kicker of likely putting most private insurance out of reach of working families.  Oh, don’t worry–your liberal friends like Soros and Buffett will still be able to buy all the healthcare they need, but everyone else is going to be priced out of the market.  All those “wealthy” people busting their humps 60-80 hours a week will get the punishment you think they deserve.

  • Bruce, thanks for making me laugh with this comment:

    While the intentions of those who would “reform” are health-care system are good, . . .

  • A diagram of the German health care system for those who may be interested;

    Mandatory health care premiums average about 14% of gross salary split between employer and employee, which covers about 68% of total health care costs. The rest is funded by co-payments, other taxes, etc. For the rich there is also private insurance.