“But the reality is that the mere fact that your health ins. co. is picking up most of the bill does not mean you’re going to use vastly more healthcare than you need.”
No, that is exactly what the research shows. If someone else is picking up the bill you are going to spend more.
“No one likes to go to the doctor.”
Oh you need to spend some time as a doctor. There is a quite a percentage of the population (especially the elderly) that quite enjoy coming to the doctor. (I have the graying hair to prove it.)
“A system that emphasizes bureaucratic review….”
Did you read my post? I want much much less bureaucracy. The only area that I think that the government might and I mean might be of help is that of standardizing certain clinical recommendations and thus reduce defensive medicine.
You can increase the supply of doctors all you want but this is not going to decrease healthcare costs because we are not dealing with a supply and demand situation. The government and the insurance companies do not reimburse for services based on the number of doctors but on the complexity of the medical visit or the procedure rendered. If healthcare was pure fee for service then the supply of doctors would matter. If there were many doctors in a given area then competition would lower the cost of their services. As it is now, doctors do not set their own prices.
And your solution is???? Eliminate health insurance? Abolish medicare?
It isn’t going to happen. You just have to deal with the payor system the way it is. There’s no sense in beating your head against the wall about the fact that some people demand more healthcare than you would like. It’s just the way it’s going to be.
You can tinker with it, but you’re not going to achieve any meaningful gain. We’ve been doing that for decades. It hasn’t worked. You’ve just got to recognize that there will be some waste, and accept it. In fact, the same is true in every industry. You do the best to eliminate waste, but restricting supply as the remedy is sort of like shooting a mosquito with a bazooka. Better to deal with a few mosquito bites.
So we’ve got no choice but to take that “unnecessary” demand as a given, and to focus on other alternatives to reduce costs. Increasing the number of doctors might increase the availability of unnecessary healthcare, but it’s also going to increase the availability of necessary healthcare, and that is what I’m concerned about.
I would be willing to bet money (and that’s what I’d be doing) that increasing the supply would reduce my healthcare expense, not increase it. In fact, if it weren’t so expensive to obtain healthcare, I suspect that more people would be willing to go it alone, without the aid of health insurance, and that in itself would reduce the impact of the disfunctional payor system.
This is no knock on the fact that you are a doctor (because the reality is that a lot of people who aren’t doctors share your view), but every time someone brings up the idea of increasing the supply of doctors, there is an immediate outpouring of negativism at the thought, in my view mostly designed to focus attention on other alternatives, leaving the idea of increasing the number of doctors as the last possible resort.
That’s why we’ve spent 40 years or so debating this issue, and devising solutions that don’t work. No one wants to adopt the solution that is offered by every basic economic textbook, i.e. a free market approach. Everyone has their own reasons for opposing it. Doctors fear that it will negatively impact their incomes. Most of the healthcare industry panders to the opinions of the physicians. Policy makers either have a vested interest in the system failing so that they can institute a socialized system, or a vested interest in not rocking the boat.
Unfortunately, this is going to end in a crisis of greater proportion than the one we have as more baby boomers approach old age. And despite what the socialist zealots think, socialism is not going to “save the day.” We might end up with socialism, but it will still be a system that is a pathetic failure.