When in the midst of a high-energy presidential primary season, conversations inevitably migrate toward the often-taboo subject of politics. While talking with one of my clients recently, the presidential campaign came up; specifically, the issue of federalized health insurance. My client operates a physician recruiting firm, TimeLine Recruiting, so I asked him if he’d thought about how government insurance would affect his business.
The resulting conversation got me thinking: just how badly do we need Uncle Sam to pay our national insurance bill? Is the system really broken? How do we address the issue of health insurance in the U.S.?
After conducting a little research and applying some common sense, I came to the conclusion that, while there is a health care crisis in America, it’s not from a lack of insurance. As Spot-On’s cranky Libertarian-in-residence, you might have anticipated that decision, but hear me out on this one.
The crisis we face is because we’ve got a rapidly shrinking supply of doctors and a rapidly growing supply of patients. What good is universal health care when patients can’t find doctors to treat them?
The dwindling supply of doctors is already being felt in America’s poor rural and urban communities. TimeLine does a lot of business finding good doctors for places that have gone years without the kind of specialists seriously sick people need. Without the right doctor nearby, patients may need to drive an hour or more to get treatment – or go without. Even with the right doctor nearby, wait times to see the doctor may be weeks.
Here’s a shocking statistic: the medical education system produces about 8,000 new doctors per year, but 35,000 become eligible for retirement. The math doesn’t work. Worse, low job satisfaction levels have many younger doctors considering leaving their careers.
Why? Few doctors these days fit the wealthy golf-bag toting stereotype. It’s a high-stress profession that fewer people find attractive. It costs a great deal of money to become a doctor and also to practice medicine. Capital equipment and medical supplies are hugely expensive. Staff salaries add to the burden, but steadily rising liability insurance premiums are what can be a deal-breaker for the doctor trying to make it in a small practice in a poor community. After all, physicians have bills to pay and mouths to feed just like the rest of us.
Doing some research for an opinion essay written by TimeLine’s CEO and carried by Hearst, I learned that, according to the Massachusetts Medical Association, 37% of physicians in my home state are considering leaving medicine because of the rising cost of liability insurance, the constant threat of being sued, and increasing administrative burdens, among other factors. Adding 50 million more patients to the system and increasing the red tape that always comes with government programs will certainly accelerate the exodus of doctors from the profession.
I won’t bother to speculate about what federalized healthcare in the U.S. might look like; we have examples already. Just read about conditions at Walter Reed Army Medical Center. The Washington Post’s Dana Priest and Anne Hull provide a pretty good illustration of the scandalous conditions there as well as at the country’s network of Veterans Administration hospitals.
So what do we do to fix the problem? The best approach is to reform our economy to promote the creation of quality jobs right here at home – jobs that will rebuild the middle class and allow people to obtain private insurance through their employers. Social engineering and economic experimentation via the tax code, or a massive tax spend on a national insurance program will not work. Creating good jobs here on American soil will.
A fundamentally sound economy will naturally create more and better incentives for those considering a career in medicine. It will also stanch the flow of doctors exiting the field.
But instead of a frank discussion about real problems and real solutions in health care, we’re being sold a bill of goods made up of magical fixes from inefficient, unreliable government. “This time we’ll get it right, Mr. and Mrs. Voter,” they say. “We give you our word.”
Don’t believe it. Politicians are terrific snake oil salesmen but when the wagon leaves town, the only thing that’s changed is the guy peddling elixir has your money. You’re still ailing, and there’s no doctor in sight.