In economics the theory of supply and demand governs price, availability, and demand for a given product or service. If the supply and ease of production of a commodity is high, and demand for the product is low, then the price must fall in order for any selling to occur. Conversely, high demand for a scarce commodity generates a high price point. Such would be, or rather should be, the case in medicine, relatively speaking, as not everyone can practice medicine safely and effectively (supply is limited) while the demand is steadily increasing.
Well, what happens when the government steps in and artificially lowers the price? What's happening in Texas is that the rate at which physicians are dropping out of Medicare is accelerating.
Two years after a survey found nearly half of Texas doctors weren't taking some new Medicare patients, new data shows 100 to 200 a year are now ending all involvement with the program. Before 2007, the number of doctors opting out averaged less than a handful a year.
“This new data shows the Medicare system is beginning to implode,” said Dr. Susan Bailey, president of the Texas Medical Association. “If Congress doesn't fix Medicare soon, there'll be more and more doctors dropping out and Congress' promise to provide medical care to seniors will be broken.”[...]
The opt-outs follow years of declining Medicare reimbursement that culminated in a looming 21 percent cut in 2010. Congress has voted three times to postpone the cut, which was originally to take effect Jan. 1. It is now set to take effect June 1.
Just wait. The coercive power of the state will need to be employed ever tighter in order to "make the system work" what with all these greedy, uncaring physicians turning their backs on needy seniors. And the result, as I wrote before the health care bill was passed, will be a future dearth of people wanting to pursue careers in medicine. Sure, some will still do it for altruistic reasons, or for reasons of scientific inquiry. But you're going to lose many who have the aptitude and the desire but don't wish to have their future economic mobility and security hamstrung by an oppressive federal government.
Well, look on the bright side. Most of those that opt not to pursue medicine will be lawyers, or study finance and work for Goldman Sachs.
5/18/10 1400: More, from Scott Gottlieb, MD, in the Wall Street Journal.
Consolidated practices and salaried doctors will leave fewer options for patients and longer waiting times for routine appointments. Like the insurers, physicians are responding to the economic burdens of the president's plan in one of the few ways they're permitted to.
For physicians, the strains include higher operating costs. The Obama health plan puts expensive new mandates on doctors, such as a requirement to purchase IT systems and keep more records. Overhead costs already consume more than 60% of the revenue generated by an average medical practice, according to a 2007 survey by the Medical Group Management Association. At the same time, reimbursement under Medicare is falling. Some specialists, such as radiologists and cardiologists, will see their Medicare payments fall by more than 10% next year. Then there's the fact that medical malpractice premiums have risen by 10%-20% annually for specialists like surgeons, particularly in states that haven't passed liability reform.
The bottom line: Defensive business arrangements designed to blunt ObamaCare's economic impacts will mean less patient choice.
5/18/10 1730: Here's more, From Ed Morrissey at Hot Air, who noticed Dr. Gottlieb's article.
The end result of the consolidation that will follow ObamaCare will be increased bureaucracies and fewer choices. The mandate burden will mean fewer independent clinics and providers, thanks to the increased start-up costs. Doctors will look for the economies-of-scale approach and join a decreasing number of larger networks. Insurers will affiliate themselves with fewer providers and networks as they pare down their offerings, which will already be constrained by the mandates for minimum coverage. The so-called “Cadillac tax” will eliminate the high-end policies now offered as insurers attempt to avoid the ruinous taxes and fees imposed on those plans.
Take this out to its logical endpoint and what do you have?
That's right. Single payer. What was that about a "trojan horse?"