Interesting story in the WaPost this morning on the shortage of primary care physicians, and the likelihood that the problem will worsen with any program designed to put more of the 46 million "uninsured" into the system.
Does anyone believe greater government play in the system is going to solve this problem? If anything, more government will likely move things the other way, and here's why.
Let's face it...being a doctor just ain't what it used to be. Doctors used to be independent contractors, independent owners/practitioners etc running a business as a partnership or LLC. Now, most work for corporations/hospital systems, and they abide by corporate pay-scales. That is, as these corporations have sought to control costs, they have sought to control compensation. Big government getting more involved will exert even more negative pressure on the compensation system. Lower wages (or the perception thereof) combined with what is still a grinding system of education and training for MD's will invariably result in an exacerbated shortage.
It's also one thing to have to deal with corporate policies which are almost unilaterally focused on maximizing profit. At least the doctors can understand the context of the policies under which they are obligated to work when signing on with an HMO or the like. What will quite likely send our medical professionals' very full brains into disequilibrium is attempting to find some sensible contextual reason when dealing with the policies of government.
ReplyDelete"If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it."
I believe the "...shortage of primary care physicians.."is a man-made one. One of the larger health care organizations near me appears to be moving towards a model where all primary care is performed by an overwhelming majority of non-doctors - Physicians Assistants and Nurse Practicioners. A cost-cutting measure for sure. The doctors are mostly in the speciality practices, ortho, neuro, cardio, etc.
ReplyDeleteMe thinks this isn't a reaction to a shortage of primary care doctors, it is the reason there are not as many. There isn't as many needed as before in "the new model" in our brave new world.
When you consider the amount of time and expense that goes into becoming a physician, it is certainly not for the faint of heart. With the prospect of a national health care system taken over by the government controlling potential income, the prospect of going into debt to become a doctor is downright frightening. I fear that the government will scare the best and brightest to law school to sue the mediocre doctors that we may eventually be stuck with.
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