Government Control Won’t Reduce Costs
By ALLAN DOBZYNIAK, MD
In some “Medicare for all” plans sponsored by Democratic presidential candidates, doctors could face a 40 percent pay cut.
The government as a monopsony would be the single employer of physicians and the sole arbiter of compensation. Rumor has it that the government could dictate specialty training and even practice location. If Cuban doctors are considered enslaved, by some, how would the outcome described here lead to a different scenario for American physicians?
Then there are those who believe that physicians competing with nurse practitioners and physician assistants is the way to reduce healthcare costs.
Honestly, what would be the point of an additional six to 10 years of physician education and training if it produced nothing of value to patient care?
Added to the mix is the ever-present mendacity of the American Medical Association acting as the most potent union in the United States. The AMA, dubbed by many a populist organization, is comprised of only about 10 percent of the nation’s physicians. The organization increasingly is mired in political correctness and of minuscule influence in healthcare evolution.
None of these has or would have any significant effect on the cost of healthcare, but would create seriously negative consequences to patients’ access to care and on the profession of medicine.
Affordability is really a catchall word that leads nowhere. Does it mean reducing annual deficits related to entitlements, crushing physician compensation, increased regulation, increasing hospital competition, eliminating the Certificate of Need laws, stifling innovation, less patient choice, ratcheting up rationing, crushing drug companies, or repeating the disaster of pricing controls?
Terms such as “shifting risk”, “HMOs”, “ACOs”, “outcomes”, and “value-based care” are likewise meaningless jargon for increasing burdensome administrative bloat and price controls by administrative coercion.
Until each of these issues is dealt with individually with the goal of comprehensive reform based on solid economic principles, it will simply continue to be some sort of repetition of unworkable schemes producing nothing of value but more predictable together with the certainty of unpredictable negative consequences.
Basic economics tells us scarce resources cannot be free, and they are rivalrous. Healthcare is no exception.