In 2006, Massachusetts mandated health insurance and initiated subsidized insurance for people who couldn’t afford private insurance. This suddenly gave a few hundred thousand people access to standard health care who didn’t have it before. However, Massachusetts now has a shortage of primary care physicians to tend to those people.
There are several reasons for this, but a one is that young doctors at the beginning of their careers carry whopping student loan debts, which inspires them to gravitate to higher-paying specialties like surgery. Another is that primary care physicians tend to have higher administrative costs.
(BTW, I’ve seen the primary care physician shortage held up as a reason to avoid universal health care — if everybody can see a doctor, then there will be waiting lines. Like in Canada. I know you love that argument as much as I do.)
At the Boston Globe, doctor and novelist Stephen J. Bergman writes,
THE REASONS for the shortage of primary-care doctors have been clearly described: low pay, long hours, the crossword puzzle of insurance forms required to get paid – which leads to three administrative assistants for every doctor. But the issue is being framed using a classic tactic of the private insurance industry: in order to make ends meet, cut payments to higher-paid specialists and redistribute to primary-care doctors. This pitting of doctor against doctor is a classic tactic of the disastrous healthcare system in which we find ourselves
I would add that if the only way supply can meet demand is by artificially tweaking the system — either by redistributing pay or by keeping large numbers of people uninsured, thereby suppressing demand — does this not tell us that a “free market” solution to the health care crisis will not work?
I want this paragraph on a lot of billboards —
The issue isn’t that primary-care doctors get paid less than cardiac surgeons, but that the system of healthcare rests on insurance companies and their CEOs making huge profits. No amount of cost-cutting can save enough money to support a for-profit system. The only solution is a universal, government-run healthcare system. Surveys suggest that a majority of Americans and doctors desire this. Any plan that puts private insurance in anything other than an optional, “concierge” system for the rich is just whistling past the graveyard of American healthcare.
See also Robert Reich.