I’m always impressed with the quality of the articles at the Disease Management Care Blog, and Jaan Sidorov’s article about primary care docs and government-sponsored health insurance is no exception. he acknowledges that his article is a simplistic take on what would happen if uninsured Americans were suddenly covered by government run health insurance. But the simplicity of it is exactly what will appeal to readers looking for an easy to understand explanation of the laws of economics as they apply to health care.
When I read the article, it raised a few questions for me, and I wanted to address them here. First, of the 2000 patients that each doc currently sees, we have to assume that at least some of them would switch to government-run health insurance if it became available. Some of them might be currently uninsured and paying out of pocket to see the doctor. Others might be stretching their budget to pay for private health insurance, and just barely getting by. And still others might have a health insurance policy that they don’t like, and would be willing to give government-run health insurance a chance. Whatever the reasons, there’s a good chance that even if a doctor in this situation were to stop seeing new patients, the impact of government-run health insurance would still be felt. Depending on the reimbursement rates that the doctors receive, some of them might find it necessary to accept new patients – even if they aren’t wild about the terms of their health insurance – in order to continue to make a living.
Another factor would be the market demand for doctors in general. If the 46 million Americans who currently don’t have health insurance were to be covered by a government-run program, it makes sense to assume that the overall demand for health care would increase, relatively quickly. I know this is a simplistic view, but it seems that an increased demand for health care would lead to an increased number of people seeking careers as health care providers. Obviously this wouldn’t happen overnight, but it would likely be a factor. Then again, there’s been a nursing shortage for as long as I can remember, so maybe not…
Overall, I think Jaan’s article serves as a reminder that the health care system is built around patients and providers. Patients are in the system because they have to be, but the same is not the case for doctors, nurses, and other health care providers. Whatever health care reforms we consider – here in Colorado, and on a federal level – we need to make sure that we don’t create a system that is so distasteful to providers that they decide they’d rather spend their time doing something else instead of medicine.
I found the DMCB article in last week’s Cavalcade of Risk, hosted at Wisdom from Wenchypoo’s Mental Wastebasket.