Brad DeLong Sees the Light
Massachusetts has been walking down this exchange-and-public-program-expansion road for six years now, since Mitt Romney signed RomneyCare. Massachusetts has been vacuuming up doctors and nurses from Costa Rica and elsewhere and still has been finding that the cost of treating your state population is higher when 97% are insured than it was when 88% were insured. And there aren’t enough loose doctors and nurses in the rest of the world for the ACA [Affordable Care Act] to vacuum up enough of them to meet the needs of not 1 state but 50 states.
…What is your guess as to what will happen if the ACA works for access, works for quality, works for coverage — but the extra health-care workforce needed isn’t there, and the lines start to get longer.
More. Pointer from Tyler Cowen via Arnold Kling.
At what point does a shortage in the medical field provide an incentive for people to enter it because doctors are so needed and it’s easy to get a job?
I understand this is a market-distorting subsidy, but I know at some level with the economy as bad as it is, people have an incentive to enter fields where they know the jobs are?
Many of the health reform advocates that support ObamaCare mistakenly assume the Medical Home Model (for lack of a better term) is the only way to treat patients. Purportedly, we all need a doctor who knows our name and medical history by heart. That has not existed since Andy Griffith’s Mayberry, which (ignoring for the moment that the show was fictional) was a period in history when doctors had few effective treatments. Your doctor knew you by name, and he also knew your heart disease, hypertension or diabetes would likely kill you in your 60s.
DeLong is correct that there isn’t enough excess doctors in the world to treat 32 million more people who will suddenly want to consume more medical care. Of course, the medical establishment (and the public health establishment) will fight modernization that would make it easier for treat patients outside the 3000-year old physician model.
Coverage and Quality mean nothing if I can not receive care.
Hooray more taxes to support healthcare.
Cindy, that is a very interesting question. The supply of doctors is fairly inelastic compared to the rest of the labor market.
The NCPA has proven time and again that the Medicare and Medicaid programs pay physicians less. So traditional labor supply curves would argue that physicians would then value their leisure time more.
I’m just guessing that unemployment among doctors is already very low (gotta pay off those student loans).
Without wage increases, or decreased barriers to employment as a physician.. from an economics standpoint — i’d hazard: No. The supply of doctors won’t increase very much in response to demand, and in fact that unless government pay scales increase to match market (what private insurers are willing to pay) that existing physicians will work less.
So.. call your local congressman, and tell him “no more whammies.”
Please someone correct my economicking if i’m wrong.
How does it mak sense when they say that the ACA is working to improve access, quality and coverage while at the same time the physicians, nurses and medical assitants needed are not available? This shortage of staff will immediately cause a decrease in access to care, which will lead to poor quality and a lack of coverage. So “what is your guess as to what will happen if the ACA works for access, works for quality, works for coverage”? Easy. It won’t.
going along with what kyle said- just because there is a demand for doctors doesn’t necessarily make it an attractive career option for many people considering the money and time that they spend in medical school
let the market solve the problem
it is called supply and demand
demand increases supply is tight wages go up more people see healthcare as an attractive occupation nursing schools expand programs
technology as with every other profession is increasingly moving the use of software, computers, connectivity of networks and robots into the workplace particularly into the realm of docs.
as with so many other institutions healthcare is in a time of significant transition and their will be bumps in the road and dislocation of resources and individuals used to doing things as they were in the 19th and 20th centuries—but it is necessary
No doubt, the massive flooding of potential patient into a market-service with limited supply will hike up prices. That said, there is always the possibility that market forces can respond accordingly and increase their service through various creative measures. Overtime, this may bring the prices under-control.
Throwing money at this will only increase the costs. Those handed money (to throw) will get some additional service. Others will get a little less service. Those will be the immediate effects. There will be some slight increase in supply, perhaps a slight increase in immigration of medical staff.
Most of the talk about reducing cost is really about reducing service. The service reduction includes slightly longer queueing, less time in the doctor’s office, with a few real efficiency gains thrown in.
You will know we really intend to do something about providing service to more folks when we start providing money to increase seats in medical schools. Not scholarships, but seats.