Thursday, September 17, 2009

What the Doctors Think

Will Americans soon be too sick to work, produce, invest, and generate new prosperity? That’s one conclusion you can draw from a new series by Investor’s Business Daily, which reveals that doctors are overwhelmingly opposed to a government takeover of health care (including the Baucus plan). Just as important, IBD reports that any government-based health-care overhaul will exacerbate the growing shortage of doctors in this country.

IBD/TIPP found that 71 percent of physicians believe that government cannot cover 47 million more people without significant rationing of health care. And nearly half of the doctors polled say they would retire early if Congress passes the proposed overhaul.

IBD/TIPP surveyed nearly 1,400 physicians for its series. In written responses, doctors have pointed to lower pay, increased government mandates, and less freedom to practice as reasons for the physician shortage. In particular, Medicare and Medicaid, which essentially are running half of our health-care system, continue to pay below-market reimbursement rates that are putting doctors out of business.

Primary-care physicians are the worst off. The American Academy of Family physicians reports that primary-care doctors need a 30 percent pay raise in order to survive. They’re not going to get it under Obamacare, or Obamacare Lite. In fact, physician payments will move lower should any of the various House and Senate plans pass.

The Massachusetts Medical Society, operating in a state that has implemented a Washington-like universal-overage plan, reports that primary-care doctors are in short supply for a fourth straight year, that the percentage of primary-care practices closed to new patients is the highest ever recorded, and that seven of 18 specialties — dermatology, neurology, urology, vascular surgery, and obstetrics-gynecology, in addition to family and internal medicine — are all in short supply.

On top of all that, enrollment in medical schools is already declining. By some estimates, the nation will have 159,000 fewer doctors than it needs by 2025.

So what exactly are we supposed to do about this doctor shortage? The easy answer is to create incentives for new doctors. And for that matter nurses. And for that matter hospital space. We should expand and grow the entire free-market health-care system, which up until recently was America’s greatest growth industry.

But these government plans will do just the opposite. They will shrink private care and private insurance. They will reduce jobs. And they may well undermine American health and wellness.

Everyone should read the IBD series and consider the health-care debate from the standpoint of the doctors. That’s something that hasn’t been done yet. But it’s darn important.