Debate Over Doctor Shortages
In my lifetime I’ve been right about some things and wrong about others. But here is one thing I feel certain about: the absolutely worst thing we can do in health policy is to make health care free at the point of delivery and try to supply all the care people demand at a price of zero.
In the Wall Street Journal the other day I wrote:
ObamaCare says that health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force. What would that involve? In the American Journal of Public Health (2003), scholars at Duke University calculated that arranging for and counseling patients about all those screenings would require 1,773 hours of the average primary-care physician’s time each year, or 7.4 hours per working day.
In other words, doctors will be spending virtually all of their time giving tests to healthy people! They will have no time to do all the other things we want doctors to do.
Here is Aaron Carroll’s response:
Look, there’s nothing inherently wrong with what he’s saying. The issue I take with the piece is that the problem he’s describing has absolutely, positively nothing to do with ObamaCare.
We have a doctor shortage in the United States. There are too many people who want to see a doctor, and not enough doctors to see them. This means that sometimes people have to wait to see a physician. This happens now.
I report. You decide.
Au contraire. The coming doctor shortage has everything to do with ObamaCare.
Thankfully doctors still have discretion when advising patients on what tests to administer.
The Duke study (Primary Care: Is There Enough Time for Prevention?) finds that “Our current system of preventive care delivery—provided by physicians seeing patients for acute visits and for periodic preventive health evaluations—no longer meets national needs. New methods of preventive care delivery are required, as well as a clearer focus on which services can be best provided, and by whom.”
There’s a shortage of doctors willing to treat patients with public insurance. The wait for an appointment can be long and the attention (while in the exam room) can be short. The demand for doctors will skyrocket as Baby Boomers age. When Baby Boomers who are physicians retire, a huge chunk of doctors will go away. Demographics are causing a problem. The Affordable Care Act will exacerbate the problem. Another aspect of the problem is the convoluted way doctors are licensed. To understand how this came about read Paul Starr’s book, The Social Transformation of American Medicine.
Goodman’s math on this shows the hard truth that these bureaucrats can’t seem to take.
The doctor shortages in this country could get worse if the Canadians go to a free-market healthcare system before we do, drawing doctors from the U.S. to practice in Canada.
Doctor shortages are just one of the problems we are facing now that Obamacare is (likely) to be implemented.
You make a great point about Obamacare and the measures taken for office visits.
Clear confirmation that unlawful regulations deteriorate the market.
I think it’s pretty clear, as Mr. Herrick pointed out, doctor shortages will only continue to worsen.
Doctor shortages, Paul Starr… @Devon Herrick, why do I have a sneaking suspicion you are about to propose we re-adopt HillaryCare?