A physician shortage is one of the many catastrophes conservatives claim will befall the country if Obamacare isn’t repealed. Alyene Senger, in a Heritage Foundation Issue Brief, thinks declining Medicare and Medicaid reimbursement rates combined with obnoxious bureaucratic oversight will cause already dissatisfied physicians to retire in droves and dissuade younger people from becoming doctors. Jeff Tangney, CEO of the physician social media site Doximity, Inc., predicts we’ll be short 90,000 to 150,000 physicians by 2025 as 30 million people obtain health insurance. The unstated implication is “You’re screwed because some undeserving, lazy moocher is getting the health care you worked so hard for, and YOU’RE paying for it.”
This is wrong on so many levels I’m not sure where to start.
Overwhelming the system?
The uninsured have always been there but now they will have health insurance. Barring an unexpected pandemic, thirty million people aren’t going to become sick on October 1, 2014. People won’t be trampling each other in a Black Friday-like rush to the doctor’s office. More may now seek preventative care, but not necessarily. My well-insured sister-in-law hasn’t had a Pap smear in 24 years.
The scourge of Medicare and Medicaid?
Physicians were predicting disaster before Medicare was enacted in 1965. Ronald Reagan railed against “socialized medicine” in 1961. Now, they love it because it pays them for taking care of old people. My late father-in-law’s internist got a hundred bucks for each five minute visit.
More people on insurance means more revenue for physicians and hospitals instead of bad debt write-offs. The same holds for Medicaid. Many physicians refuse to see Medicaid patients; those that do accept those patients out of necessity or a sense of moral obligation. More people will be eligible for Medicaid but the Feds will be throwing more money into the pot, so what’s not to like?
Doctors leaving in droves? I don’t think so.
The independent, solo practitioner is almost extinct. More than half of all physicians are employed by a hospital or a healthcare system and don’t have to worry about the bureaucratic headaches of private practice. Younger physicians find this attractive because they want a life outside of practice. Employers like them because their young minds can be molded into the corporate way. Established physicians like the idea of a guaranteed salary and potential productivity bonuses. And many, if not most, physicians will shut up and endure for the right price. Those of us nearing retirement may get out early because we’re tired, but Obamacare provides a convenient excuse for the complainers.
For the past thirty years I’ve heard physicians complain that “the practice of medicine isn’t fun anymore.” But they are also bound by the golden handcuffs. The average physician income is $259,000/year and even primary care physicians average a healthy $189,000/year. It’s hard to walk away from all that money. Trust me; I still see a lot of luxury cars in doctors’ parking lots, including one Tesla Model S.
You will still get the medical care you need. Everyone should.