The N&O published an interesting article today. An ex-insurance executive changes careers because he was tired of negotiating lower pay rates for doctors. Years later he sees the government health care reform plan will have the same effect. Doctors, not insurance companies, will face the greatest loss; and when doctors lose, patients lose.
It’s the chronic problem of unintended consequences. Even those government bureaucrats with the best intentions, have little control on real outcomes.
We’ve already seen it happen with Medicaid:
…care of Medicaid patients is becoming increasingly concentrated among a smaller proportion of physicians who tend to practice in large groups, hospitals, academic medical centers and community health centers. Relatively low payment rates and high administrative costs are likely contributing to decreased involvement with Medicaid among physicians in solo and small group practices.
Less pay means fewer doctors, and fewer doctors accepting new patients.
This year it is expected that Medicaid will lose $1.5 billion. $400 million in highly contested cuts have already been made, and another 11,000 more people than anticipated have signed up for Medicaid this year. Additionally, NC will receive $440 million less in Medicaid funding from the federal government next year.
Somewhere down the line – possibly quite soon – legislators will need to reconnect with reality. When costs > revenue, something has to give. Also, when you already have one system in deep need of repair, don’t create another one.
ON the other hand, most doctors are overpaid, due to overconsumption in the third party payer system, a lack of price transparency and the cartelization of the docs via the AMA. The truth is, we don’t know what the market price for a doctor’s labor is. There are just too many damn distortions created by government policy. So you’re right in part. Limiting doctor pay would compound the distortions, not mitigate them. But the labor supply of doctors isn’t the core issue here, in my opinion, though it is certainly symptomatic of dumb policy.