Free Markets, Free People

When government interferes in a market, results are predictable

And it is neck deep in health care.  So, with the passage of ObamaCare, what is the state of medicine?

Oh, just great:

The doctor is disappearing in America.

And by most projections, it’s only going to get worse — the U.S. could lose as many as 1 million doctors by 2025, according to a Association of American Medical Colleges report.

Primary-care physicians will account for as much as one-third of that shortage, meaning the doctor you likely interact with most often is also becoming much more difficult to see.

Now, 2025 is 9 years away and, the “primary-care physician” is the star of ObamaCare because he or she is the “gatekeeper”.  However, which doctor is the worst compensated of all doctors?

Why the gatekeeper of course.  And, that’s by design.  Government design:

Starting salaries in high-paying specialties can range from $354,000 (general surgery) to $488,000 (orthopedic surgery), while primary-care fields tend to bring a sub-$200,000 starting salary, from$188,000 (pediatrics) to $199,000 (family medicine), according to a Merritt Hawkins report.

Why?

The pay disparities reflect America’s “fee for service” health-care model, which compensates providers based on the number and type of services they complete, and which inherently favors specialists.

Anyone know what entity pushes the “fee for service” model?  Can you say “Medicare”?  And yes, the insurance companies follow their lead. Hence, we have doctors in the primary care field looking at specializing because as gatekeepers, they are mostly the chief “referrer” to the other medical specialties … the ones that get paid more.

Wow … what a surprise then that the field of primary care is looking at a future shortage.  It’s another one of those “human nature” things that central planners simply can’t wrap their brains around.

Then there’s the exacerbation of the problem by ObamaCare:

The shortage is one that’s been stewing for decades but of late was exacerbated by passage of the Affordable Care Act, which increased the number of insured people and along with that the demand for doctor access, experts say.

As we’ve mentioned countless times, having insurance does not equal having care.  And as the number of gatekeepers dwindles, that problem will become even more acute.

Of course everyone knows what the answer that will be put forth by our political leaders don’t they?  Why of course more government.  You know, like the UK, where the former head of the NHS just died because the operation she needed was postponed 4 times.

~McQ

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11 Responses to When government interferes in a market, results are predictable

  • It would appear a certain amount of karmic justice has more than likely been rendered in the UK.

    Here in la Republica Chiquita we should also consider the effect the government has had on college tuition by screwing with that market and driving up the prices.
    And from where do our next generation of gatekeepers get their education? eh?
    Truly our friends in government are more than hip deep in causing the problems. Everywhere you look, their helping hand is evident.
    Bernie will fix that I bet.

    Fear not however, now that we’ve re-approached Cuba Barack can probably convince them to send us boatloads of their doctors to treat us.
    But not until after the Fidel publicly pisses all over whatever agreements they might come to, because the Obama administration is heavily into being publicly pissed on, just ask Iran.

  • Frankly, this might have happened anyway, given how many doctors are Boomers, ready to retire.
    That said, having a dysfunctional government doesn’t help either.

    The VA is in the news again, this time “losing” the paperwork for the veterans who went to private care because the VA couldn’t do it’s job.
    Now we have doctors who aren’t being paid, and the the union that represents VA workers claiming the private channel has failed because doctors are refusing to take more VA patients.

  • “…was exacerbated by passage of the Affordable Care Act, which increased the number of insured people and along with that the demand for doctor access, experts say.”

    Heck, I predicted that years ago. If that’s all it takes, I’m an expert too.

    The pay disparities reflect America’s “fee for service” health-care model, which compensates providers based on the number and type of services they complete, and which inherently favors specialists.

    I think there is a little more to it than that. I like my GP, but I am not going to let him put in a pacemaker. I will gladly pay extra to my cardiologist, a specialist who further specializes in electrocardiology, to do it.

    Most of it is supply and demand, and you can’t do much about that. Lawyers, accountants, and restaurants work the same way. The higher the level of expertise, the fewer practitioners there are, and the more they can charge.

  • This is just going to increase the pressure to renovate medicine from top to bottom. Most of what doctors do, including practically all primary care doctors, is information processing. They look at your information, decide what else they need to know, and then spit out a treatment. There’s no reason whatsoever that deep learning programs can’t replicate that and do a better job within the next ten to fifteen years.

    We’re seeing the early phases as routine stuff moves to nurse practitioners. Eventually they’ll be able to handle more with the proper diagnosis tools at their disposal.

    Long term, a lot of surgery will be done by robots, and I wouldn’t even be surprised to see computer programs replace many psychiatrists in the next twenty years.

    That’s one of the big reasons I thought Obamacare was so stupid and misguided. While it will increase pressure to innovate by raising demand, it will dampen innovation with its byzantine rules. Plus, it will freeze in place an insurance system designed for the medical field as it existed thirty years ago instead of being designed for the one we will/should have in ten or twenty years.

    • This is why the Left will only seek national implementation of such programs. So when they fuck things up, you don’t have a comparison that can’t be arm waved away.

    • Nurse Practitioners, yes; also Physician’s Assistants. Stuff that does NOT take sixteen years to learn.

      And as you indicate, a lot of machines will be doing what humans USED to do.

      Something quite similar is already happening at the ophthalmology clinic I go to: young “techs” do EVERYTHING except the final dilate-the-eye exam. And *everything* the techs handle is automated: “Please look through the eyepieces there, don’t blink, hoo-o-old it. OK, fine;” and they tear off the strip of paper with the results on it and stick it in your folder. The machine performs the test, the techs act as the interface between patient and machine. The physician is only present during the last 10 minutes of the appointment, to summarize the results to the patient and make his recommendations.

      Hands-off medicine, coming soon to a clinic near you.

  • What part of Socialized Medicine did I get wrong?
    Not here, but on other forums I was chided for stating what was clearly going to come to pass.
    Sarah Palin, (with all her folksy witticism people rightfully grimaced at) predicted death panels and pain pills being issued instead of treatment and she was crucified for it. Like so many things she was made sport of, those issues turned out to be spot-on.
    It isn’t enough to be right, you have to be a Billy Mays to get your point across.

    • But for Sarah Palin to have been right, numerous other asshats with a national forum would have to have been wrong.
      Of the two sides, which is most likely to continue to be portrayed as having been wrong?

  • You know, like the UK, where the former head of the NHS just died because the operation she needed was postponed 4 times.

    — Feel good story of the day