Posted by
Buster Foghorn on Thursday, August 13, 2009 9:18:35 AM
My wife and I write to express our concern about physician access under the health care reform proposals, especially as reform might impact Medicare.
President Obama apparently promised—“YOU WON'T BE WAITING IN ANY LINES'—at Portsmouth, N.H. on July 11, 2009. But by every conceivable metric, we see no reason to be sanguine about his ability to deliver on his promise. We see only a shrinking number of physicians. Reduced physician compensation plans for Medicare in the reform bills (increasing the health-care wedge) and other changes will inevitably make the practice of medicine less attractive to foreign trained doctors who presently immigrate to the U.S.; to foreign trained students graduating from U.S. medical schools that currently remain here to practice medicine; and to college graduates contemplating graduate school. In short, with the contemplated reform, where will the doctors come from if Congress is to keep the President’s promise—no waiting in lines?
How can you avoid delays, rationing, and a less than compassionate government system if you don’t first set a goal to increase the number of physicians? As a practical matter, I believe that any medical reform that fails to first address physician shortages will fail to capture the confidence of a majority of Americans. For example, Deroy Murdock (Government Medicine Kills) reported the following about waits in Canada:
In 2008, the average Canadian waited 17.3 weeks from the time his general practitioner referred him to a specialist until he actually received treatment,” Pacific Research Institute president Sally Pipes, a Canadian native, wrote in the July 2 Investor’s Business Daily. “That’s 86 percent longer than the wait in 1993, when the [Fraser] Institute first started quantifying the problem.
And so, I write to ask if you have looked at the incentives for medical careers in France? Apparently, France is trying to deal with the cost issues right now, but they have at least worked to increase the number of providers—medical school is paid for by the government, and malpractice insurance is much cheaper. Here is an excerpt from a recent Wall Street Journal report: France Fights Universal Care’s High Cost by David Gauthier-Villars.
France claims it long ago achieved much of what today's U.S. health-care overhaul is seeking: It covers everyone, and provides what supporters say is high-quality care. But soaring costs are pushing the system into crisis. The result: As Congress fights over whether America should be more like France, the French government is trying to borrow U.S. tactics.
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In France, "If you are in medical care for the money, you'd better change jobs," says Marc Lanfranchi, a general practitioner from Nancy, an eastern town. On the other hand, medical school is paid for by the government, and malpractice insurance is much cheaper.
In 2000, the World Health Organization ranked France first in a one-time study of the health-care services of 191 countries. The U.S. placed 37th.
To recruit doctors our military has long had a medical education program. Upon graduation the doctor is required to serve on active duty for a number of years. Why can’t Congress create a program to fund medical school and malpractice insurance for those who commit to accept Medicare, Medicaid and public option patients for a set number of years? Why not a goal to at least double the number of providers, thereby ensuring an increased number of providers who will willingly accept patients covered through government programs?