First Mr. Sowell today, on the "costs" of healthcare:
There is a fundamental difference between reducing costs and simply shifting costs around, like a pea in a shell game at a carnival. Costs are not reduced simply because you pay less at a doctor's office and more in taxes-- or more in insurance premiums, or more in higher prices for other goods and services that you buy, because the government has put the costs on businesses that pass those costs on to you.
Joust The Facts, October 29, "Creating Scarcity In Medicine The Easy Way":
As a provider, out there trying to keep my own practice alive, pay my employees appropriately and have their own pay keep up with inflation (at a minimum), deal with rising supply costs, rising bureaucracy costs, rising health care costs, and rising overhead, Medicare and Medicaid don't cut it. Doctors drop Medicare because they can't pay the bills on Medicare patients, and Medicaid pays significantly less. Scarecrow looks at the governmental macroeconomics of health care reform rather than the effects on medical practices, seeing the forest but missing the trees. And I think that is what a lot of legislators in Washington are doing, and they're missing the individual trees. This isn't just a game where if you shift dollars around from pocket to pocket they multiply miraculously.
Mr. Sowell, on physicians in the future:
If doctors' incomes were cut in half, that would not lower the cost of producing doctors through years of expensive training in medical schools and hospitals, nor the overhead costs of running doctors' offices.
What it would do is reduce the number of very able people who are willing to take on the high costs of a medical education when the return on that investment is greatly reduced and the aggravations of dealing with government bureaucrats are added to the burdens of the work.
Joust The Facts, op. cit.:
It's difficult enough to become a doctor, what with an extra four years of school, an extra 3 to 6 years of residency and then fellowship training, and then face the gradual buildup of a practice as your community slowly becomes comfortable with you as the go-to person when they find themselves in need. If the payoff after all that effort is that you'll annually be at risk of bankruptcy based on which way the country's breezes are blowing, then fewer and fewer bright, motivated individuals will make the effort - and delay their gratification - to get there.
It's good to hear others join my voice in making a chorus.