Doctors don’t like Obamacare

Bruce Kesler highlights the largest ever survey of doctors on the subject of Obamacare — and they don’t like it.

I can already hear the pro-Obamacare people saying, “Well, they don’t like it because it’s going to be more efficient and therefore cuts into their profits.”

Think about that for a minute.  You can have profitable efficiency (that would be a good private sector business, such as McDonalds or Apple) or you can have allegedly efficient unprofitability (and I can’t think of an example).  Let’s assume that, in a government-run program, efficiency is even possible.  And let’s take it as a given that doctors will lose money.  What happens then?

The answer is easy:  good doctors leave a system that doesn’t reimburse them.  In England, the good doctors have left and there are regular stories in the British papers about the dreadful doctors the NHS brings in from overseas. In the former Soviet Union, medicine became a predominantly female job because it was so low status — and the smart women didn’t want to do it.

Doctoring has traditionally been profitable, but it’s been an earned profit:  the top students spend four years in undergrad, four years in medical school, one year as an intern (at which time s/he can practice in prison), two years as a resident (at which time s/he can become a basic internist or family practitioner), and then one to seven years developing a specialty.  So that’s eleven to eighteen years of training.  Human nature says that, if there isn’t a big reward at the end of that trajectory, good people aren’t going to do it.  They’ll go somewhere else where they can get a larger return for the same or less effort.

And if you’re really curious what bad doctoring looks like, listen to this radio story, about a girl who was bitten by a shark and then got seen by a bad doctor.