Single payer = physician shortages

April 26, 2007

More evidence from Canada:

If you believe such shortages can’t happen in the United States, think again. Medicare already presides over a Byzantine system of price controls that it is planning to expand. This system has already created primary care shortages in many rural areas in this country, and its planned expansion will create more.

If the voters are foolish enough to bestow the presidency on a proponent of “single-payer” health care in 2008, a shortage of physicians is just one of the hardships they will receive for their trouble.



Related posts:

  1. Physician shortages and national security
  2. "Single-payer medicine inevitably leads to shortages, suffering and death"
  3. Obama invokes single-payer
  4. Single payer: The assault continues
  5. Single-payer supporters, be careful what you wish for
  6. Single-payer: Is the ivory tower this naive?
  7. Single payer myths


KevinMD.com on Facebook


  Follow on Twitter   Subscribe



{ 11 comments }

1 Anonymous April 26, 2007 at 3:42 pm

If implemented on a national scale then there would be nowhere for the providers to run to. America and particularly the States that pander (place in your verb that you find appropriate) the most to physicians are the holy grail. If implemented on a national scale, there will be no more pasture on the other side of the proverbial hill where the grass is greener. This is not to say that other factors would not continue to effect provider geographical distribution but single payer vs. multiple payer would not be one of them as all systems would be single payer.

2 Anonymous April 26, 2007 at 4:13 pm

Actually we could run to fee-for-service and dump all payers (ie Medicare). Much to the chagrin of the single payer cheerleaders and unlike other countries such as the UK and Canada, the US Constitution will prevent making private practice illegal. Additionally, there are great careers in hair transplantation, laser hair removal, Botox injection, and phalloplasty! If all else fails, then many may dump medicine and start flipping houses, go to Wallstreet, or even get an online law degree and start chasing ambulances. The options are limitless.

3 Anonymous April 26, 2007 at 6:05 pm

Right. We are not slaves and have the freedom to do something else for a living or even go somewhere else. About a third of the docs can emmigrate back to their countries of origen. I know one guy already who went back to Latin America and is thriving.

4 Anonymous April 26, 2007 at 6:07 pm

I have wondered about Hong Kong or other cities in China with large English speaking communities. I don’t know anywhere else where the midical profession is freer than in under that dictatorship. Sort of proves that democracies can the be the enemy of liberty.

I will not accept slavery as the price to pay for practicing medicine, or even for living. Live free or die.

5 Anonymous April 26, 2007 at 6:09 pm

It funny you mention green grass, because who will ever work in a rural facility if the pay is the same everywhere with single payer. I’d move to the city. Why would you work in North Dakota or Rural Kansas when you can work in Texas, California or Florida and make the same per patient. Part of the way reimbursement is set up now is what the market will bear. You want to live on the east coast you will make less plain and simple and every physician knows that. When patient demand and visits go up and you have the same number or providers exactly what is the incentive for customer service. There is none. I have patients upset that they can’t get a MRI the same day they are seen by a physician. Customer service drives the marketplace right now. How do you think that person is going to feel if we have single payor and they have to wait 6 months for their MRI scan like they do in Canada. When there is no incentive to please the patient, i.e. customer, how is a patient’s perceived quality not going to suffer. Health and wellbeing statistics are quoted out the ying yang, but all my patient wants is their MRI and they want it done yesterday.

6 Anonymous April 26, 2007 at 6:10 pm

There will not be a shortage of physicians, just a shortage of ethical physicians who put the patient first instead of playing to the system.

But that is already true in many sectors. Third party payment of any kind places the ethical requirement to put patients first at odds with natural law which dictates that the payor calls the tune.

7 Anonymous April 26, 2007 at 7:53 pm

Once again: I am SO glad taht I see the light at the end of the retirement tunnel. And if I get pissed off any sooner than that date, I’ll finally answer that solicitation I get every year from the hair transplantation industry.

8 Anonymous April 26, 2007 at 9:04 pm

I’ll say again increased demand for services with a finite resource (physicians).
Explain how that will work with statements backed up by zero facts.

Physicians have the highest level of public trust of any profession and are deemed the most ethical of all professions in the U.S.
Higher than clergy, teachers, policeman, you name it. Harris Interactive showed 85% of people trust their physician. Have something to back up a statement before you spout off about physician ethics. Its not an ethical issue, its a supply and demand issue.

9 Evan April 27, 2007 at 11:40 am

I am curious what the actual facts are. Is there no physician shortage in the US? If there is one, why does our payment system ameliorate it in ways that Canada’s doesn’t. If there is a physician shortage in Canada, why is this shortage in Canada caused by their payment system? Does the fact that it’s freezing cold in Canada affect the physician supply too?

10 Elliott April 27, 2007 at 6:22 pm

Before getting all worked up about this, realize that this post is based on a study from the Fraser Institute which has never, to my knowledge, published an accurate report of anything having to do with Canadian healthcare. Kevin loves them though.

11 Anonymous April 29, 2007 at 6:49 am

CMS and Congress will keep residency/med school dollars and slots at a minimum, because there is an abundance of data showing that the more physicians there are the more money they will end up paying into Medicare, etc. The AMA/medical societies have a minimal role in this except by providing some advise that is typically ignored. The only way they will increase numbers is if the clamor from the media and the masses grows.

Comments on this entry are closed.

Previous post: Doctors should Google themselves

Next post: Are our physician leaders out of touch?

Site Meter