Obamacare Likely To Lead To Greater Doctor Shortage -- Except Where Free Market Still Prevails
The New York Times' Annie Lowrey and Robert Pear report serious doctor shortages now and to come -- not surprising since becoming a doctor in an increasingly socialized system seems like not a very good way to make a living (or pay back massive loans for med school).
But, surprise, surprise, there's no shortage of the doctors whose pay depends upon the free market -- plastic surgeons and dermatologists:
"We have a shortage of every kind of doctor, except for plastic surgeons and dermatologists," said Dr. G. Richard Olds, the dean of the new medical school at the University of California, Riverside, founded in part to address the region's doctor shortage. "We'll have a 5,000-physician shortage in 10 years, no matter what anybody does."Experts describe a doctor shortage as an "invisible problem." Patients still get care, but the process is often slow and difficult. In Riverside, it has left residents driving long distances to doctors, languishing on waiting lists, overusing emergency rooms and even forgoing care.
"It results in delayed care and higher levels of acuity," said Dustin Corcoran, the chief executive of the California Medical Association, which represents 35,000 physicians. People "access the health care system through the emergency department, rather than establishing a relationship with a primary care physician who might keep them from getting sicker."
A Manhattan friend of mine who's part of an elite liver transplant team at one of the country's top hospitals sometimes has to wake up at 3 a.m. when the liver arrives in the cooler and then work many hours. When it's a Medicaid patient, he makes $30 an hour. He told me this five or more years ago -- maybe the rate has gone up to $32 or $35 since then...or down to $25.
The point is...would you spend years and years slogging away in med school and in residency to make $30 an hour while paying Manhattan rent? It's really not what he signed on for. (And he's a great and kind guy, who isn't just hot for a dollar.)
That's sad-most RN's make more than $30 an hour, in cities. Every so often I'll see a post on one fo the mom boards I'm on, asking if anyone knows a Dr accepting patients that take whatever insurance or, more commonly, Medicaid. It's already getting hard for them to find a Dr. It's just going to get worse. They, of course, blame the Drs and not the government. Sad.
momof4 at July 29, 2012 9:09 AM
Amy Alkon
http://www.advicegoddess.com/archives/2012/07/29/obamacare_likel.html#comment-3289596">comment from momof4Amazing that people are indignant that others won't just give away their services, or come close.
Amy Alkon at July 29, 2012 10:12 AM
One of the things many small government advocates cite as wastes of money is the overpayment of government employees. With their pensions and their overtime, teachers and cops and bureaucrats all make too much money on the public dime. Fine. Elected officials tend to pay people too much in order to make themselves more electable.
But you can't make that argument and at the same time claim that when government takes over payment of doctors from over-generous insurance companies, that doctors won't get paid enough to make it work their while.
clinky at July 29, 2012 12:45 PM
Sure you can clinky, those doctors are not government employees. They don't draw a constant salary from Uncle Sam, but an individual payment per patient per procedure.
Robert at July 29, 2012 1:28 PM
The fallacy in your argument is that a doctor (or doctors group, or hospital, care company, etc.) has the ability to negotiate with Aetna, or BCBS, or Cigna, or Kaiser for the rates they find acceptable. If the health insurance company and the doctor can't come to an agreement, the doctor can tell the patient to look elsewhere for service, or pay cash and the patient gets to go back to the insurance and try to be reimbursed.
The doctor isn't refusing service, they just want to be compensated. If the patient can't or won't pay --then they have a choice go elsewhere or die.
So then the next argument is that if you are a doctor -- to keep your license or DEA card -- you have to accept Medicare/Medicaid. so then the overwhelming majority of your patients are government slugs at $30 payment per visit at 15 minutes with the patient. The two nurses and the receptionist/PA labor cost is $75 per hour plus bennies. Then throw the office rental, lights, water, etc.
So the doctor gives up his practice and license and becomes an assistant at a vet clinic. What are you going to do? Have cops drive over to his house and force him to see patients at gunpoint?
Then add in that part of Obamacare has a portion that doctors can no longer own hospitals. So you will have the bureaucrats and bean counters owning and running hospitals, not healthcare professionals.
Jim P. at July 29, 2012 1:53 PM
Keep in mind also the huge cost of insurance that most doctors must carry. Many if them work for months just to pay for that.
And despite what prevailing opinion is, the majority of the doctors I work with are in it for the care, not for the cash.
UW Girl at July 29, 2012 2:25 PM
Another thing to take into account is how expensive professional degrees are now. A few generations ago one could actually work their way through medical school. This is impossible now.
If after eight years of schooling and then residency you're looking at getting paid $30 an hour, getting a medical degree does not pencil out. The student loans you've accrued mean you'll have them paid off about the time you're ready to retire.
I told my son if he was interested in becoming a doctor, the most sensible thing would be to join the military and have Uncle Sam foot the bill. After school and whatever term of service he would need to serve, he would then be able to practice medicine without any debt.
Janet C at July 29, 2012 7:34 PM
I have a colleague whose wife is in her last year of residency as an eye surgeon. The amount of student loan debt she carries is staggering. It's a good thing she loves her work because she absolutely has to bring down a large salary to clear those loans, which they expect to have paid off when they are in their fifties.
Astra at July 30, 2012 5:31 AM
Switzerland has a mandate to by insurance, and govt insurance for the poor, and we have a lot of doctors and the health care is good.
Just to be optimistic.
NicoleK at August 1, 2012 4:50 PM
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