Your Call: Access or Choice. Neither?
Article by Robert Sampson
President Obama promised that after implementation of his new health plan, Americans would be able to keep their doctors and insurance plans and that there would be more access and choice in health care delivery.
The media offers a lot of coverage on the shortage of primary care doctors and how new legislation will exacerbate the problem. One major goal is to increase access to care for all Americans – particularly lower income citizens – by providing health insurance options to more people in order to make care more affordable.
While the right to health care is debated, everyone generally agrees that better access and more affordable health insurance is good. If people are insured they’ll make better preventative care choices and see their doctors regularly. Effectively, this means fewer trips to the emergency room for the common cold and less occurrence of heart disease-induced surgeries.
However, 20 to 45 million additional patients represent huge demand that will overwhelm the current pool of doctors. Basic supply and demand teaches there will be a problem: new, government-induced insurance cannot create the tens of thousands of new physicians needed overnight. A shortage of doctors will become an increasing part of life. However, other types of legislation – or the free market – could encourage more students to become doctors and more nurses and physicians assistants to take on changing roles.
Many newly-insured patients and those who already depend on government-sponsored care will have greater access in theory; however they will have long wait times as doctors close their practices to new/Medicare/Medicaid patients. Short of time or immigration, only intrusive federal regulation can remedy this situation.
According to the WSJ, changes which would be the envy of any economic central planner are underway to cut insurance company costs. The plan caps overhead or the inverse of “medical-loss ratios” at 15% for units that offer health plans to large businesses (20% on individual/small business plans). A common response may be “Great… those greedy insurance executives make too much!” however this tightening misses the point and has some interesting consequences.
